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Risk factors for a poor outcome following surgical treatment of cervical spondylotic amyotrophy: a multicenter study

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Abstract

Introduction

Cervical spondylotic amyotrophy (CSA) is characterized by muscle atrophy in the upper extremities without gait disturbance. However, the indications and outcomes of surgical treatment for CSA have not been clarified. The purpose of this study was to determine the risk factors for a poor outcome following surgical treatment of CSA.

Materials and methods

We performed a retrospective review of CSA in patients from 1991 to 2010 through a multicenter study. We collected information regarding age, type of muscle atrophy, preoperative manual muscle test (MMT), duration of symptoms, high-intensity areas on T2-weighted MR images, low-intensity areas on T1-weighted MR images, levels of spinal canal stenosis, cervical kyphosis and surgical procedures (laminoplasty, anterior cervical discectomy and fusion and posterior spinal fusion), and calculated overall risk factors related to a poor outcome following surgery. Univariate analyses and multivariate logistic regression analysis were performed to identify correlates of a poor outcome.

Results

Fifty-nine patients, 95 % male (56 patients), were included in our analysis with a mean age of 59 years (range 32–78 years). Eighteen patients did not improve after surgery. Symptom duration (OR = 1.263), preoperative MMT grade (OR = 0.169) and distal type of CSA (OR = 9.223) were all associated with an increased risk of a poor surgical outcome.

Conclusion

Early surgery is recommended for CSA patients in whom conservative treatment has not been successful. We also recommend surgery for patients who have severe preoperative muscle weakness or have the distal type of CSA.

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Abbreviations

CSA:

Cervical spondylotic amyotrophy

CSM:

Cervical spondylotic myelopathy

ALS:

Amyotrophic lateral sclerosis

MMT:

Manual muscle test

HIA:

High-intensity areas

LIA:

Low-intensity areas

ACDF:

Anterior cervical discectomy and fusion

PSF:

Posterior spinal fusion

OR:

Odds ratio

EMG:

Electromyography

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Acknowledgments

We are grateful to all the staff of Nagoya Spine Group for allowing us to study their patients. And, We also wish to thank F. Kato, Y. Sakai, Y. Katayama, K. Satake, K. Hirano, A. Muramoto, H. Matsui, T. Matsumoto, and Y. Ishikawa for their assistance with data collection.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, 4668550, Japan

    Ryoji Tauchi, Shiro Imagama, Zenya Ito, Kei Ando & Naoki Ishiguro

  2. Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan

    Hidefumi Inoh

  3. Department of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya, Japan

    Yasutsugu Yukawa

  4. Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan, Japan

    Tokumi Kanemura

  5. Department of Orthopaedic Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Koji Sato

  6. Department of Orthopaedic Surgery, Kariya TOYOTA General Hospital, Kariya, Japan

    Yuji Matsubara

  7. Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Japan

    Atsushi Harada

  8. Department of Orthopaedic Surgery, Hachiya Orthopaedic Hospital, Nagoya, Japan

    Yudo Hachiya

  9. Department of Orthopaedic Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan

    Mistuhiro Kamiya

  10. Department of Orthopaedic Surgery, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan

    Hisatake Yoshihara

Authors
  1. Ryoji Tauchi
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  2. Shiro Imagama
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  3. Hidefumi Inoh
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  4. Yasutsugu Yukawa
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  6. Koji Sato
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  7. Yuji Matsubara
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  8. Atsushi Harada
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  9. Yudo Hachiya
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  10. Mistuhiro Kamiya
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  11. Hisatake Yoshihara
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  13. Kei Ando
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  14. Naoki Ishiguro
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Corresponding author

Correspondence to Shiro Imagama.

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Tauchi, R., Imagama, S., Inoh, H. et al. Risk factors for a poor outcome following surgical treatment of cervical spondylotic amyotrophy: a multicenter study. Eur Spine J 22, 156–161 (2013). https://doi.org/10.1007/s00586-012-2506-6

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  • DOI: https://doi.org/10.1007/s00586-012-2506-6

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