Analysis of five specific scores for cervical spondylogenic myelopathy |
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Authors: | Hans-Ekkehart Vitzthum Kristina Dalitz |
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Institution: | (1) Neurosurgical clinic of the University Leipzig, Liebigstr. 20, 04103 Leipzig, Germany |
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Abstract: | The ability to compare various results that measure clinical deficits and outcome is a necessity for successful worldwide
discussion about cervical spondylogenic myelopathy (CSM) and its treatment. There is hardly any information in literature
how to value and compare outcome assessed by different scores. In a retrospective study we objectively evaluated the Nurick-score,
Japanese-orthopaedic-association-score (JOA-Score), Cooper-myelopathy-scale (CMS), Prolo-score and European-myelopathy-score
(EMS) using the data of 43 patients, all of whom showed clinical and morphological signs of CSM and underwent operative decompression.
The scores were assessed pre- and postoperatively. The correlation between the score-results, anamnesis, clinical and diagnostic
data was investigated. All the scores show a statistically significant correlation and measure postoperative improvement.
With exception of the Prolo-score all scores reflect clinical deficits of CSM. The Prolo-score rates the severity of CSM on
the state of the economic situation above clinical symptoms. The main differences of the scores are shown in the number of
patients showing postoperative improvement, varying between 33% (Nurick-score) and 81% (JOA-score). The recovery-rates, as
a measure of the cumulative improvement of all the symptoms, show less variation (23–37%). The differences of the recovery-rate
were only statistically significant between JOA-score, Nurick-score and EMS (P < 0.05), whereas all the other scores showed no significant differences. To assess the postoperative successes, the evaluation
of the recovery-rate is essential. There is no significant difference in the recovery-rate amongst the majority of the scores,
which allows a good comparison of the results from different studies. Nevertheless, it is always important to differentiate
the therapy results of CSM published worldwide. |
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Keywords: | Cervical myelopathy Scores Outcome Recovery rate Preoperative validation Postoperative validation |
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