A Singh1, H A Crockard. 1. Department of Surgical Neurology, The National Hospital for Neurology and Neurosurgery, London, UK.
Abstract
BACKGROUND: We developed a 30 m walking test as a quantifiable measure of severity of cervical spondylotic myelopathy (CSM), which will be of use in determining the effects of decompressive surgical treatment. METHODS: Preoperative measurements were made in 41 patients with CSM of 30 m walking times, number of steps taken over this distance, myelopathy disability index (MDI), and Nurick scores. The walking factors were compared with a similar number of age-matched and sex-matched controls. The individuals in the study were patients with CSM and no other relevant pathology consecutively referred for decompressive surgery to the National Hospital for Neurology and Neurosurgery. FINDINGS: Both walking time and the number of steps taken were significantly worse in pre-operative patients than in controls. The walking data were highly reproducible over three trials. Postoperatively, there was a significant improvement in walking time (p=0.0018) and number of steps taken (p=5.87 x 10(-6)). Only two of 41 patients were worse postoperatively. There was also a significant improvement in MDI (two-tailed Wilcoxon, related samples; p<0.0001) and Nurick scores (two-tailed Wilcoxon p<0.0001) postoperatively. The preoperative and postoperative walking scores were significantly and equally correlated with the MDI and Nurick scores. INTERPRETATION: Timed walks are an easily performed, quantitative, and valid means of assessing CSM and the effects of surgery.
BACKGROUND: We developed a 30 m walking test as a quantifiable measure of severity of cervical spondylotic myelopathy (CSM), which will be of use in determining the effects of decompressive surgical treatment. METHODS: Preoperative measurements were made in 41 patients with CSM of 30 m walking times, number of steps taken over this distance, myelopathy disability index (MDI), and Nurick scores. The walking factors were compared with a similar number of age-matched and sex-matched controls. The individuals in the study were patients with CSM and no other relevant pathology consecutively referred for decompressive surgery to the National Hospital for Neurology and Neurosurgery. FINDINGS: Both walking time and the number of steps taken were significantly worse in pre-operative patients than in controls. The walking data were highly reproducible over three trials. Postoperatively, there was a significant improvement in walking time (p=0.0018) and number of steps taken (p=5.87 x 10(-6)). Only two of 41 patients were worse postoperatively. There was also a significant improvement in MDI (two-tailed Wilcoxon, related samples; p<0.0001) and Nurick scores (two-tailed Wilcoxon p<0.0001) postoperatively. The preoperative and postoperative walking scores were significantly and equally correlated with the MDI and Nurick scores. INTERPRETATION: Timed walks are an easily performed, quantitative, and valid means of assessing CSM and the effects of surgery.
Authors: M Abdulhadi Alagha; Mahmoud A Alagha; Eleanor Dunstan; Olaf Sperwer; Kate A Timmins; Bronek M Boszczyk Journal: Eur Spine J Date: 2017-01-19 Impact factor: 3.134
Authors: Kingsley O Abode-Iyamah; Stephanus V Viljoen; Colleen L McHenry; Michael A Petrie; Kirsten E Stoner; Nader S Dahdaleh; Nicole M Grosland; Matthew A Howard; Richard K Shields Journal: Neurosurgery Date: 2016-11 Impact factor: 4.654