Discrepancy between functional recovery and cutaneous silent period change in surgically treated degenerative cervical myelopathy: a prospective pilot study.
Spinal Cord
; 57(12): 1076-1083, 2019 Dec.
Article
en En
| MEDLINE
| ID: mdl-31213658
ABSTRACT
STUDY DESIGN:
Exploratory researchOBJECTIVES:
Cutaneous silent periods (CSPs) that reflect the inhibitory spinal cord reflex, can sensitively detect spinal cord dysfunction, and contribute to the diagnosis of degenerative cervical myelopathy (DCM). However, CSP changes after DCM surgery related to functional improvement have not been reported.SETTING:
University hospital in Nankoku, JapanMETHODS:
CSP recorded at four time points-before surgery, 3, 6, 12 months after surgery-were investigated in 31 hands of 16 DCM patients. CSPs were categorized as follows normal, delayed onset latency, shortened duration, onset delay with shortened duration, and absent CSP. Myelopathic symptoms were evaluated by the Japanese Orthopaedic Association score (JOA score).RESULTS:
Normal CSPs were observed in five hands (16%) before surgery and six hands (19%) twelve months after surgery (P > 0.05). Either onset delay or shortened duration or both were observed in 18 hands (58%) before surgery and 16 hands (52%) twelve months after surgery (P > 0.05). Absent CSPs were observed in eight hands (26%) before surgery and nine hands (29%) twelve months after surgery (P > 0.05). Measured values of onset latency and duration also did not change throughout the study period (P > 0.05). On the other hand, JOA scores improved after surgery. (P = 0.003).CONCLUSIONS:
CSP abnormalities persisted after surgery in most cases, indicating irreversible damage of the intramedullary reflex circuit. JOA score recovery without CSP recovery provides insight into postoperative neural recovery in DCM.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Periodo Refractario Electrofisiológico
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Enfermedades de la Médula Espinal
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Vértebras Cervicales
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Recuperación de la Función
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Electromiografía
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Spinal Cord
Asunto de la revista:
NEUROLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Japón