Preoperative factors that predict fair outcomes following surgery in patients with proximal cervical spondylotic amyotrophy. A retrospective study.
Spinal Cord
; 58(3): 348-355, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31745245
ABSTRACT
STUDY DESIGN:
Observational cohort studyOBJECTIVES:
To investigate preoperative factors that predict fair outcomes following surgery in patients with proximal cervical spondylotic amyotrophy (CSA) using electrophysiological and neurological findings.SETTING:
Yamaguchi UniversityMETHODS:
54 patients with proximal CSA who underwent surgical treatment of the cervical spine were enrolled. Erb-point stimulated compound muscle action potentials (CMAP) were recorded from the deltoid and biceps brachii muscles. We computed the ratio of affected to normal side CMAP amplitudes in two muscles (deltoid and biceps brachii) and regarded the mean ratio (CMAP-R) as representing the severity of neural involvement. Pre- and postoperative strengths of the most atrophic muscles were evaluated using manual muscle testing. Improvements in strength were classified as excellent (5 grades recovered), good (more than one grade recovered), fair (no improvement), or poor (worsened).RESULTS:
Surgical outcomes were excellent in 26 patients, good in five, fair in 16, poor in seven. Patients with fair outcomes had lower CMAP-R than those patients with excellent and good outcomes [P = 0.0099, odds ratio = 0.89 (95% confidence interval, 0.81-0.97; for a change of 10%)]. Eight patients (15%) had a C5 palsy.CONCLUSIONS:
CMAP-R could be used as a reliable predictive factor related to a fair surgical outcome. We must pay attention to the incidence of C5 palsy after surgery.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atrofia Muscular Espinal
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Avaliação de Resultados em Cuidados de Saúde
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Músculo Esquelético
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Potencial Evocado Motor
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Espondilose
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Período Pré-Operatório
Tipo de estudo:
Etiology_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Spinal Cord
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Japão