[Clinical course of post-laminectomy cervical spondylitic myelopathy].

INTRODUCTION AND

OBJECTIVE

To study the postsurgical clinical course of spondylitic myelopathy.

PATIENTS AND

METHODS

We assessed 39 patients admitted to the Departments of Neurology and Neurosurgery of the Hospital Clinico Quirúrgico Hermanos Ameijeiras, Cuba, with a confirmed diagnosis of spondylitic myelopathy who had decompressing laminectomies during the period between January 1996 and December 1997.

RESULTS

Of the predicted variables, there was predominance of an age under 60 years (51.3%); male sex (71.8%); a history of cervical trauma and habitual dangerous physical activity in 38.5% and 41% respectively. The duration of preoperative symptoms was less than one year in 46.2%. The vertebral level most often involved was C5-C6 (97.4%). In 51.3% three levels were affected: 100% of the patients had stenosis in the zone of maximum compression; 28.2% had congenital stenosis of the canal and 66.7% had partial block shown on myelography or magnetic resonance studies of the cervical spine. There was clinical improvement in 78.4% after one month, in 91.9% after 3 months and in 94.6% after 6 months; only 2 patients had not improved on completion of the study. Motor and sensory function of the legs improved more than motor function of the arms and sphincter.

CONCLUSIONS

The variables which influenced the degree of improvement were: age, duration of the symptoms, number of vertebral levels affected, presence of blockage and functional state. After application of the multiple regression model, it was seen that the duration of preoperative symptoms is an important predictor of the postoperative clinical course.