The Prognosis of Patients with Cervical Spohdylotic Myelopathy
Wang Yu-Lin, Tsau Jyh-Chaur, Huang Mao-Hsiung
Department of Rehabilitation Medicine, Kaohsiung Medical College Hospital, Kaohsiung, Taiwan
Purpose: For the purposes of identifying possible prognosis factors and comparing the results of patients with cervical spondylotic myelopathy received conservative treatment versus operative treatment.
Method: 56 patients who cervical spondylotic myelopathy was diagnosed during the period 1988 to 1993. Informed consent and a completed functional evaluation were obtained from 31 patients via physiatrist's visits. 17 patients (mean age 52 years old) received conservative treatment and 14 patients (mean age 50 years old) received operative treatment. For the conservative group, the average follow-up was 54 months and for the operative group, the average duration (from symptom and sign onset until operation) was 23 months. According to "The Japanese Orthopaedic Association Scale" and "The Recovery Rate Scale ", we have evaluated the functional change of patients during the follow-up period and different possible prognosis factors have been analyzed.
Result: There is no significant difference in recovery rate whether patient's age is over 50 years old or whether the individual Pavlov ratio is smaller than 0.7. Interestingly, patients who received operation (anterior or posterior approach) within 18 months since symptom and sign onset were found to have a better recovery rate (p=0.03). Conservative management leads to 35% improvement and the operative management leads to 43% improvement.
Conclusion: The results of proper cases selection and operation are superior to conservative treatment. If a patient has received a conservative treatment, routine re-evaluation is then very important for the early dectection of progressive compression myelopathy signs.
CONSERVATIVE TREATMENT OF SPINE DEFORMITIES
L. Dimitrova, L. Ugrinovoska, Z. Cvetkovic (Institute for medical rehabilitation, Skopje, Medical faculty, University "Kiril i Metodi" - Skopje, Republic of Macedonia)
The goal of this paper is to exhibit the results of the treatment of idiopathic scoliosis parallel with kinezitherapy and application of electrical surface stimulation.
Method: Kinezitherapy program and LES application.
Result: In 30% of the cases there was some improvement, in 70% the state was unchanged and no case was worsened.
Conclusion: We consider that treatment with kinezitherapy and LES is completely justified, in a sense of lessing i.e. prevention of progression of the idiopathic scoliosis.