BACKGROUND: Postoperative prognosis of the hemihypalgesia in patients with Brown-Séquard-type myelopathy (BSM) caused by cervical lesions is of great interest to surgeons. However, there are very few reports discussing the postoperative prognosis of BSM. METHODS: We evaluated the prognosis of BSM using the criteria of the Japanese Orthopaedic Association (JOA) score in 16 (seven ossification of the posterior longitudinal ligament [OPLL], 5 cervical spondylosis [CS], and 4 disc herniation patients) out of 233 surgically treated patients with cervical diseases. The mean follow-up duration was 2 years and 11 months. RESULTS: After surgery, none of these patients showed complete resolution of hemihypalgesia, although the most rostral level of hemihypalgesia moved in a caudal direction in 13 patients (81%), whose recovery ratios of JOA score were significantly better than those of hemihypalgesia-level-persisted patients. In our BSM series, OPLL occurred most frequently and the anterior element compressing the spinal cord existed most frequently in the central area of the vertebra (44%). Postoperative improvement in the motor function of the legs in the disc herniation group was significantly better than in the OPLL and CS groups (p < 0.05, respectively). There were no significant differences in the functional prognosis between the BSM and non-BSM patient groups. CONCLUSIONS: BSM patients can expect almost the same functional outcome as non-BSM patients, with the exception of the disappearance of hemihypalgesia.
BACKGROUND: Postoperative prognosis of the hemihypalgesia in patients with Brown-Séquard-type myelopathy (BSM) caused by cervical lesions is of great interest to surgeons. However, there are very few reports discussing the postoperative prognosis of BSM. METHODS: We evaluated the prognosis of BSM using the criteria of the Japanese Orthopaedic Association (JOA) score in 16 (seven ossification of the posterior longitudinal ligament [OPLL], 5 cervical spondylosis [CS], and 4 disc herniation patients) out of 233 surgically treated patients with cervical diseases. The mean follow-up duration was 2 years and 11 months. RESULTS: After surgery, none of these patients showed complete resolution of hemihypalgesia, although the most rostral level of hemihypalgesia moved in a caudal direction in 13 patients (81%), whose recovery ratios of JOA score were significantly better than those of hemihypalgesia-level-persisted patients. In our BSM series, OPLL occurred most frequently and the anterior element compressing the spinal cord existed most frequently in the central area of the vertebra (44%). Postoperative improvement in the motor function of the legs in the disc herniation group was significantly better than in the OPLL and CS groups (p < 0.05, respectively). There were no significant differences in the functional prognosis between the BSM and non-BSM patient groups. CONCLUSIONS: BSM patients can expect almost the same functional outcome as non-BSM patients, with the exception of the disappearance of hemihypalgesia.