Abstract:
STUDY DESIGN:A retrospective cohort of prospective data. OBJECTIVE:Determine the frequency of various symptoms in a surgical cohort of cervical myelopathy (CM). SUMMARY OF BACKGROUND DATA:CM can be difficult to diagnose as there is no sine qua non "myelopathic symptom." Despite extensive literature, the likelihood or frequency of symptoms at presentation remains unclear. MATERIALS AND METHODS:A total of 484 patients treated at a single academic center were reviewed. Preoperative symptoms included: axial neck pain; upper extremity (UE) pain; UE sensory or motor deficit; lower extremity (LE) sensory or motor deficit; and sphincter dysfunction. It was noted whether a symptom was the chief complaint (CC) and/or one of a list of overall symptoms (OS) reported by the patient. Magnetic resonance imaging was assessed for the maximal cord compression level and T2 hyperintensity. RESULTS:The most common CC was UE sensory deficit (46.5%), whereas the most common OS were UE and LE motor deficits (82.6% and 81.2%). Neck pain was significantly less common (32.6% CC, 55.4% OS), and sphincter dysfunction was rare (0.6% CC, 16.5% OS). UE pain as a CC was significantly higher when the maximal compression involved a more distal level. The presence of T2 hyperintensity was negatively associated with neck pain but positively associated with sensory and motor deficits of LE. CONCLUSIONS:The most common CC in CM related to UE sensation, whereas the most common OS related to upper and lower motor function. UE pain was more common with more distal cord compression. Those with T2 hyperintensity had worse myelopathy and were less likely to have neck pain, but more likely to have LE symptoms. To our knowledge, this study is the largest to quantify the frequency of myelopathic symptom presentation in a surgical population. These findings provide valuable insight into the symptomatic presentation of CM in clinical practice and can be used to better inform diagnosis and treatment in this complex patient population. LEVEL OF EVIDENCE:Level II-retrospective study.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Niu S,Anastasio AT,Maidman SD,Faraj RR,Rhee JMdoi
10.1097/BSD.0000000000000968subject
Has Abstractpub_date
2020-12-01 00:00:00pages
E448-E453issue
10eissn
2380-0186issn
2380-0194journal_volume
33pub_type
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