P.223 Correlating the pre- and post-operative subjective experience of myelopathic impairments with the objective clinical exam

Abstract

Background: Degenerative cervical myelopathy is a debilitating condition of the spinal column resulting in a progressive, clinically measurable loss of motor and sensory function secondary to spinal cord compression. We sought to correlate the patient’s subjective experience of specific myelopathic impairments with components of the objective clinical exam, to determine if the latter provides any clinically-relevant information postoperatively. Methods: Thirty-eight myelopathy patients consented to complete the mJOA questionnaire and receive a physical exam preoperatively, and 6-weeks and 6-months postoperatively. mJOA components were correlated with the physical exam using Spearman correlations with an alpha of 0.05. Results: mJOA scores for sensation and lower limb motor function correlated with the sensory and lower limb motor exams respectively, both preoperatively and 6-weeks postoperatively. mJOA scores for upper limb motor function did not correlate with the upper limb motor exam at either timepoint. Conclusions: At baseline and immediately postoperatively, patients self-report sensation and lower limb motor function accurately. However, the patients’ subjective experience of upper limb motor function does not align with clinical exam findings, suggesting either a continued need for this component of the physical exam or a need for tools that better correlate with the patient’s experience of upper limb motor impairment.