Early diagnosis of myelopathy hand improves efficacies of surgical treatment of cervical spondylotic myelopathy

Abstract

To evaluate the value of early diagnosis of myelopathy hand in improving the efficacies of surgical treatment of cervical spondylotic myelopathy. Analyses were conducted for 118 cases of cervical spondylotic myelopathy at Department of Orthopedics, Changzheng Hospital and Zhabei Campus from January 2009 to November 2012. They were diagnosed with myelopathy hand and classified by finger escape sign, 10-second grip and release test of fist along with electromyography of ill limb to evaluate the movement function of hands . They were divided into early diagnosis group with myelopathy hand (A, n = 62) and routine diagnosis group without myelopathy hand (B, n = 56) . All patients with cervical spondylotic myelopathy underwent anterior corpectomy decompression and fusion. The average follow-up period was up to 4. 1 years. Modified Japanese Orthopedic Association (JOA) score was used to evaluate neurological function preoperation and 48 months postoperation respectively. T-test of SPSS statistical software 13. 0 was used to analyze the inter-group difference of JOA scores before and after surgery. There were no inter-group significant differences in age, gender or smoking ratio. The JOA scores of groups A and B were 10. 1 ± 2. 3, 14. 9 ± 2. 0; 9. 8 ± 3. 1, 12. 1 ± 2. 3 before surgery and 48 months postoperation and the increase of JOA scores were 4. 8 ± 0. 9, 2. 3 ± 0. 6. The inter-group differences between JOA scores before and after surgery were statistically significant (P = 0. 00). And the inter-group differences between the increase of JOA scores at 48 months postoperation were statistically significant (P = 0. 00). Neurological function improves more for patients with cervical spondylotic myelopathy diagnosed with myelopathy hand in early stage than those diagnosed conventionally without myclopathy hand. And an early diagnosis of this sign may boost the surgical efficacies for cervical spondylotic myelopathy.