Article Figures & Data
Figures
- Fig. 1
A 66-year-old female patient complained of numbness of both hands and difficulty of ambulation for 7 years.: (a)X-ray lateral view of pre-operative three-level (C4-C7) CSM. segmental lordosis: 3°; (b) Preoperative sagittal MRI showing the presence of three-segment spinal cord compression associated with T2 signal changes (c) Preoperative axial MRI showing C4 - C5 large central herniated disc with reduction in cervical spinal canal diameter.
- Fig. 2
Postoperative images of the same 66-year-old female patient (a) X-ray lateral view 6 months post-operation. Fused segmental lordosis: 10°; (b,c) 6 months Post-operative flexion-extension X-ray images showed that fused segments were stable; (d) 1 year postoperative sagittal reconstruction of CT scanning showed bony fusion.
- Fig. 3
62 year old male complained of neck pain and stiffness, and difficulty of ambulation for 3 years: (a,b) X-ray lateral view of pre-operative three-level (C4-C7) CSM. Segmenal lordosis 10°, Torg/Pavlov ratio at C6: 0.6, (c) Preoperative sagittal MRI showing the presence of three-segment (C4-C7) spinal cord compression associated with T2 signal changes.
- Fig. 4
Postoperative images of the same patient at one year follow. (a) X-ray lateral view 1 year post operation. Fused segmental lordosis 20° (b, c) Rx- lateral view flexion and extension showed that all fused segment are stable. In this case an additional screw is used to secure the bone graft, obtaining good final results in relation to the fusion rate.
Tables
Grade 0 Signs or symptoms of root involvement but without evidence of spinal cord disease Grade 1 Signs of spinal cord disease but no difficulty in walking Grade 2 Slight difficulty in walking that did not prevent full-time employment Grade 3 Difficulty in walking that prevented full-time employment or the ability to perform all housework but that was not severe enough to require someone else’s help to walk Grade 4 Able to walk with someone else’s help or the aid of a frame Grade 5 Chair bound or bedridden The higher the grade, the more severe the deficit.
Motor Function Paralysis 1 Upper extremity Fine motor function massively decreased 2 Fine motor function decelerated 3 Discreet weakness in hands or proximal arm 4 Normal function 5 Motor Function Unable to walk 1 Lower extremity Need walking aid on flat floor 2 Need handrail on stairs 3 Able to walk without walking aid, but inadequate 4 Normal function 5 Sensory Upper extremity/lower extremity/trunk Apparent sensory loss 1 Minimal sensory loss 2 Normal function 3 Bladder function Urinary retention 1 Severe dysfunction 2 Mild dysfunction 3 Normal function 4 Total score 0-17 The lower the score the more severe the deficits. Normal function 16 + 17, grade 1: 12–15, grade 2: 8–11, grade 3: 0–7.
FACTOR PRE FOLLOW UP P value STATISTICAL ANALYSIS Sex Male 8 (53.3%), female 7(46.7%) NT Age at surgery (years) 64.8, SD 9.4 NT Blood loss (cc) 264.7, SD± l72.5 NT Operation time (minutes) l78.3, SD ± 55.3 NT Follow-up period (months) 29.6, SD ± 9.8 NT JOA score (points) ll.4, SD ± 2.6 l3.8, SD± l.9 0.001 (CI 95% 1.1-3.7) paired t test JOA Recovery rate (%) 38.9%, SD ± 38.5 NT NT (l) Nurick Scale 3.3, SD ± l 2.4 SD ± 0.9 0 006 Wilcoxon signed rank test SF-36 MCS 35.8, SD ± 9.7 44.5, SD ±13.9 0,049 (CI 95% 0.04 - 17.29) paired t test SF-36 PCS 33.3, SD ± 13.8 35.5, SD ±9.5 0.644 (CI 95% -7.6 - 11.9) paired t test JOA: Japanese Orthopaedic Association; NT: Not testable; SD: Standar Desviation; CI: Confidence intervals.
FACTOR PRE FOLLOW UP P STATISTICAL ANALYSIS cervical lordosis 10.8, SD ± 8.9 14.3, SD ±8.8 0.116 (CI 95% -1.618.6) paired t test Torg Ratio (mean) corpectomy level 0.66 NT Fusion rate (%) 93% NT NT: Not testable; SD: Standard Deviation; CI: Confidence intervals.
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