Publication details

Predictive factors for spondylotic cervical myelopathy treated conservatively or surgically


KADAŇKA Zdeněk MAREŠ Miroslav BEDNAŘÍK Josef SMRČKA Vladimír KRBEC Martin CHALOUPKA Richard DUŠEK Ladislav

Year of publication 2005
Type Article in Periodical
Magazine / Source European Journal of Neurology
MU Faculty or unit

Faculty of Medicine

Field Neurology, neurosurgery, neurosciences
Keywords : spondylotic myelopathy; cervical myelopathy; surgery for myelopathy; conservative treatment of myelopathy; cervical cord compressive myelopathy
Description Objectives. A prospective 3-year randomised study comparing conservative and surgical treatment of spondylotic cervical myelopathy to establish predictive factors for outcome after conservative treatment and surgery. Material and Methods. The clinical, electrophysiological and imaging parameters were examined to reveal how they characterised the clinical outcome. Statistically, pair-wise and multiple comparisons of differences were used with the independent t-test and on one-way ANOVA models followed by Tukey multiple-range tests. Results. The patients with a good outcome in the conservatively treated group were of older age before treatment, had normal central motor conduction time (CMCT), and possessed a larger transverse area of the spinal cord. The patients with a good outcome in the surgically treated group had a more serious clinical picture (expressed in mJOA score and slower walk). Conclusions. Patients should rather be treated conservatively if they a spinal transverse area larger than 70 mm2 , are of older age, and have normal CMCT. Surgery is more suitable for patients with clinically worse status and a lesser transverse area of spinal cord.
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