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Published in: European Spine Journal 1/2013

01-01-2013 | Original Article

Risk factors for a poor outcome following surgical treatment of cervical spondylotic amyotrophy: a multicenter study

Authors: Ryoji Tauchi, Shiro Imagama, Hidefumi Inoh, Yasutsugu Yukawa, Tokumi Kanemura, Koji Sato, Yuji Matsubara, Atsushi Harada, Yudo Hachiya, Mistuhiro Kamiya, Hisatake Yoshihara, Zenya Ito, Kei Ando, Naoki Ishiguro

Published in: European Spine Journal | Issue 1/2013

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Abstract

Introduction

Cervical spondylotic amyotrophy (CSA) is characterized by muscle atrophy in the upper extremities without gait disturbance. However, the indications and outcomes of surgical treatment for CSA have not been clarified. The purpose of this study was to determine the risk factors for a poor outcome following surgical treatment of CSA.

Materials and methods

We performed a retrospective review of CSA in patients from 1991 to 2010 through a multicenter study. We collected information regarding age, type of muscle atrophy, preoperative manual muscle test (MMT), duration of symptoms, high-intensity areas on T2-weighted MR images, low-intensity areas on T1-weighted MR images, levels of spinal canal stenosis, cervical kyphosis and surgical procedures (laminoplasty, anterior cervical discectomy and fusion and posterior spinal fusion), and calculated overall risk factors related to a poor outcome following surgery. Univariate analyses and multivariate logistic regression analysis were performed to identify correlates of a poor outcome.

Results

Fifty-nine patients, 95 % male (56 patients), were included in our analysis with a mean age of 59 years (range 32–78 years). Eighteen patients did not improve after surgery. Symptom duration (OR = 1.263), preoperative MMT grade (OR = 0.169) and distal type of CSA (OR = 9.223) were all associated with an increased risk of a poor surgical outcome.

Conclusion

Early surgery is recommended for CSA patients in whom conservative treatment has not been successful. We also recommend surgery for patients who have severe preoperative muscle weakness or have the distal type of CSA.
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Metadata
Title
Risk factors for a poor outcome following surgical treatment of cervical spondylotic amyotrophy: a multicenter study
Authors
Ryoji Tauchi
Shiro Imagama
Hidefumi Inoh
Yasutsugu Yukawa
Tokumi Kanemura
Koji Sato
Yuji Matsubara
Atsushi Harada
Yudo Hachiya
Mistuhiro Kamiya
Hisatake Yoshihara
Zenya Ito
Kei Ando
Naoki Ishiguro
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 1/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2506-6

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