Spine Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain.
Spine Unit. Orthopaedic Department, Vall d'Hebron Hospital, Barcelona, Spain.
Eur Spine J. 2023 Feb;32(2):584-589. doi: 10.1007/s00586-022-07506-2. Epub 2023 Jan 3.
PURPOSE: To find the cut-off values in the Myelopathy Disability Index (MDI) that will allow us to classify the severity of Degenerative Cervical Myelopathy (DCM) into mild, moderate and severe. METHODS: Cross-sectional study with prospective data collection, with a total of 64 patients diagnosed with Degenerative Cervical Myelopathy (DCM). Anthropometric, diagnostic, neurological, functional and quality of life variables were collected. A Receiver Operating Curve (ROC) was performed. The cut-off points were validated by comparing the functional status of patients in the 3 groups and their Nurick scores. RESULTS: Sixty-four patients (23 women) with a mean age of 61.97 (SD 11.57) participated in this study. The majority of patients were Nurick I (28.13%) and Nurick II (32.81%). The medium MDI was 7.36 (SD 6.66) and the mJOA was 14.08 (SD 2.57). The mild-moderate cut-off value was between 4 and 5, with an Area Under the Curve (AUC) of 0.805, sensitivity of 0.853 and specificity of 0.6. For moderate-severe, the cut-off value obtained was between 7 and 8, with an AUC of 0.862, sensitivity of 0.857 and specificity of 0.684. Patients with greater severity had significantly lower functionality, with a P-value of 0.004 in the 30 Metre Walking Test and 0.005 in the Nine-Hole Peg Test. Established severity groups were also significantly related to the different categories of the Nurick score (P-value = 0.000). CONCLUSION: MDI values between 0 and 4 correspond to mild DCM, between 5 and 7 would be moderate DCM and from 8 to 30 indicate severe DCM.
目的:寻找 Myelopathy Disability Index(MDI)的截断值,以便将 Degenerative Cervical Myelopathy(DCM)的严重程度分为轻度、中度和重度。 方法:这是一项具有前瞻性数据收集的横断面研究,共纳入 64 例确诊为 Degenerative Cervical Myelopathy(DCM)的患者。收集了人体测量学、诊断、神经学、功能和生活质量变量。进行了接收器工作特征曲线(ROC)分析。通过比较 3 组患者的功能状态及其 Nurick 评分,验证了截断值。 结果:共有 64 名患者(23 名女性)参与了这项研究,平均年龄为 61.97(SD 11.57)岁。大多数患者为 Nurick I(28.13%)和 Nurick II(32.81%)。MDI 的中位数为 7.36(SD 6.66),mJOA 为 14.08(SD 2.57)。轻度至中度的截断值在 4 到 5 之间,曲线下面积(AUC)为 0.805,灵敏度为 0.853,特异性为 0.6。对于中度至重度,获得的截断值在 7 到 8 之间,AUC 为 0.862,灵敏度为 0.857,特异性为 0.684。严重程度较高的患者功能明显下降,30 米步行测试的 P 值为 0.004,九孔插棒测试的 P 值为 0.005。不同严重程度的分组与不同的 Nurick 评分类别也有显著相关性(P 值=0.000)。 结论:MDI 值在 0 到 4 之间对应于轻度 DCM,5 到 7 之间对应于中度 DCM,8 到 30 之间对应于重度 DCM。
J Neurosurg Spine. 2016-3
Spine (Phila Pa 1976). 2018-8