Quantitative assessment of cervical spondylotic myelopathy by a simple walking test


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Abstract

SummaryBackground We developed a 30 m walking test as a quantifiable measure of severity of cervical spondylotic myelopathy (CSM), which will be of use in determining the effects of decompressive surgical treatment.Methods Preoperative measurements were made in 41 patients with CSM of 30 m walking times, number of steps taken over this distance, myelopathy disability index (MDI), and Nurick scores.The walking factors were compared with a similar number of age-matched and sex-matched controls. The individuals in the study were patients with CSM and no other relevant pathology consecutively referred for decompressive surgery to the National Hospital for Neurology and Neurosurgery.Findings Both walking time and the number of steps taken were significantly worse in pre-operative patients than in controls. The walking data were highly reproducible over three trials. Postoperatively, there was a significant improvement in walking time (p=0.0018) and number of steps taken (p=5.87x10-6). Only two of 41 patients were worse postoperatively. There was also a significant improvement in MDI (two-tailed Wilcoxon, related samples; p<0.0001) and Nurick scores (two-tailed Wilcoxon p<0.0001) postoperatively. The preoperative and postoperative walking scores were significantly and equally correlated with the MDI and Nurick scores.Interpretation Timed walks are an easily performed, quantitative, and valid means of assessing CSM and the effects of surgery.Lancet 1999; 354370-73

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