Article Figures & Data
Figures
- Figure 1
Measurements for the anterior posterior diameter of the cervical spinal canal.
- Figure 2
Preoperative T2WI sagittal MRI showing increased signal intensity (ISI). A) Type 1: faint ISI with fuzzy border (arrow). B) Type 2: intense ISI with well-defined border (arrow).
- Figure 3
Nurick grade for all advanced cervical spondylotic myelopathy patients at latest follow-up. Among patients with pre-operative Nurick grade 5, 36.4% remained the same, 27.3% improved to Nurick 4 grade, and the rest (36.3%) had a Nurick grade from 1 to 3. On the other hand, among those with pre-operative Nurick grade of 4, only 14.3% remained the same while 85.7% improved to Nurick grade 1-3.
Tables
Grade 0 Root signs and symptoms. No evidence of spinal cord involvement Grade 1 Signs of spinal cord involvement, but no difficulty walking Grade 2 Slight difficulty walking that does not prevent full-time employment Grade 3 Difficulty walking that prevents full-time employment or the ability to perform all housework, but that was not severe enough to require someone else help to walk Grade 4 Able to walk with someone else’s help or the aid of a frame Grade 5 Chair bound or bedridden Variable Nurick 4 (n=21) Nurick 5 (n=22) P-value Age (mean-years) 59.24 64.32 0.130 Surgical approach Anterior (n, %) 14 (66.7) 12 (54.5) Posterior (n, %) 7 (33.3) 10 (45.5) 0.416 Average BMI (kg) 27.61 22.66 0.584 Smoking (n, %) 14 (66.7) 5 (22.7) 0.004 Comorbidity* (n, %) 16 (76.2) 19 (86.4) 0.322 Mean duration of difficulty in walking prior to surgery (months) 6.71 4.23 0.008 Walking independently after surgery** (n, %) 18 (85.7) 8 (36.4) 0.001 Preoperative MRI features7-13: T1WI signal change (n, %) 6 (28.6) 11 (50.0) 0.151 Type of T2WI signal intensity: (n, %) Type 0 2 (9.5) 0 (0.0) 0.233 Type 1 13 (61.9) 16 (72.7) 0.449 Type 2 6 (28.6) 6 (27.3) 0.924 Average length of signal change on T2WI (mm) 8.55 18.00 0.005 Average AP spinal canal size (mm)*** 7.238 6.955 0.152 ↵* Comorbidity defined as a disease or condition that coexists with a primary disease but also stands on its own as a specific disease (for example, hypertension, diabetes mellitus),
↵** Walking independently after surgery: Nurick grade 0-3.
↵*** AP - Antero-posterior spinal canal size was calculated at the narrowest point of the space available for the cord at the site of maximum compression (mm).
- Table 3
Previous studies on the surgical results of patients with advanced cervical myelopathy.
Study Nurick grade n Mean follow-up (months) Improvement rate (%)* Ability to walk independently after surgery (%)** Ebersold et al 199536 4 7 88.2 57.14 57.1 Macdonald et al 199718 4 8 31.0 50.0 50.0 5 8 31.0 50.0 50.0 Matsunaga et al 200415 4 39 211.2 - - 5 31 211.2 16.2 - Rajshekhar and Kumar 200514 4 55 36.3 68.5 68.5 5 17 36.3 100.0 47.0 Scardino et al 20107 5 9 53.4 66.6 22.2 Current study 4 21 26.0 85.7 85.7 5 22 32.0 63.6 36.3
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