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MUSCULOSKELETAL SURGERY
Published in: MUSCULOSKELETAL SURGERY 1/2023

26-09-2021 | Laminectomy | Original Article

Predictors of poor clinical outcome in patients with cervical spondylotic myelopathy undergoing cervical laminectomy and fusion

Authors: Farid Moradi, Seyed Reza Bagheri, Hamidreza Saeidiborojeni, Sonia V. Eden, Mobin Naderi, Shafi Hamid, Sepideh Amirian, Akram Amiri, Ehsan Alimohammadi

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2023

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Abstract

Background

Cervical spondylotic myelopathy (CSM) is a common degenerative disease that arises from spinal cord compression and injury. Laminectomy with posterior spinal fusion (LPSF) is one of the most common approaches used to treat patients with CSM. The present study aimed to evaluate predictors of poor clinical outcome in patients with CSM undergoing LPSF.

Methods

We retrospectively evaluated 157 patients with CSM who underwent LPSF at our center between April 2014 and June 2019. The neurological outcome was assessed using the modified Japanese Orthopaedic Association (mJOA) scale before the surgery and at the last follow-up visit. Based on the clinical outcomes, all patients were divided into two groups [the good group (recovery rates ≥ 75%) and the poor group (recovery rates < 75%)]. The following suggested variables as potential predictors for the poor clinical outcome were compared between the two groups:age, gender, body mass index (BMI), smoking, diabetes, number of laminectomy levels, presence of signal changes in Magnetic Resonance Imaging (MRI), duration of symptoms, preoperative JOA scale, preoperative Pavlov ratio, preoperative cervical curvature, and preoperative cervical range of motion (ROM).

Results

There were 86 males (54.8%) and 71 females (45.2%) with the mean follow-up time of 24.96 ± 1.67 months. Overall, 114 patients (72.6%) had a good clinical outcome. However, 43 subjects (27.4%) failed to achieve a good outcome. According to the binary logistic regression analysis, age (odds ratio [OR], 2.14; 95% confidence interval [95% CI], 1.87–2.63; P = 0.014) and preoperative JOA scale (OR, 3.73; 95% CI 2.96–4.87; p < 0.001) were independent predictors of poor clinical outcome.

Conclusions

The results of the present study showed that age and preoperative JOA scale were predictors of poor clinical outcome in patients with CSM undergoing LPSF. These findings will be of great value in preoperative counseling and management of postoperative expectations.
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Metadata
Title
Predictors of poor clinical outcome in patients with cervical spondylotic myelopathy undergoing cervical laminectomy and fusion
Authors
Farid Moradi
Seyed Reza Bagheri
Hamidreza Saeidiborojeni
Sonia V. Eden
Mobin Naderi
Shafi Hamid
Sepideh Amirian
Akram Amiri
Ehsan Alimohammadi
Publication date
26-09-2021
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 1/2023
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-021-00731-w

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