The follow-up study of spinal decompression surgery after the onset of symptom of 19 patients with amyotrophic lateral sclerosis

Abstract

Objective To investigate the progression rate and prognosis of spinal decompression surgery after the onset of symptoms of amyotrophic lateral sclerosis(ALS).Methods A total of 329consecutive patients with deftnite or probable ALS were enrolled in the study.The patients were recorded with clinical features,history of spinal surgery,etc. Some of the patients were monitored every 3 months from visit to death or tracheostomy.Results Of 329 typical sporadic ALS,we found cervical spondylosis in 156(47.4%)patients,among whom 19(5.8%)underwent decompressive spinal surgery.No differences were noted regarding age at symptom onset,Sex and ALSFRS-R at time of diagnosis between ALS patients who underwent spinal surgery and other ALS patients.But the time from symptom onset to diagnosis was significantly longer in patients with spinal surgery((23.0±6.5)months vs(13.7±7.9)months,t=4.800,P=0.000).In the folow-up study,there were no differences in the rate of disease progression and survival between 2 groups.Conclusions All patients have inevitably progressed after spinal surgery.Although the surgery does not obviously fasten disease progression rate and shorten survival,it prolongs the time from disease onset to diagnosis,therefore should be handled with caution in patients with concurrent ALS and cervical spondylotic myelopathy. Key words: Amyotrophic lateral sclerosis; Cervical spondylosis ; Cervical vertebrae; Surgical procedures,operative; Follow-up studies; Prognosis