Cervical spondylotic myelopathy patients with prior cerebral infarction: Clinical characteristics, surgical outcomes and prognostic value of 'prior cerebral infarction'
| Autor: | Wangfei Wang, Jing Wang, Minyu Zhu, Yu Wang, Jianhong Wang, Kelun Huang, Honglin Teng, Yang Zhou |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Logistic regression Spinal Cord Diseases law.invention Intramedullary rod 03 medical and health sciences Myelopathy 0302 clinical medicine law Spondylotic myelopathy Humans Medicine 030212 general & internal medicine Risk factor Aged Retrospective Studies business.industry Cerebral infarction Cerebral Infarction General Medicine Middle Aged Prognosis medicine.disease Hyperintensity Surgery Treatment Outcome Cervical Vertebrae Female Spondylosis Neurology (clinical) business Neurological impairment 030217 neurology & neurosurgery |
| Zdroj: | Clinical Neurology and Neurosurgery. 175:34-39 |
| ISSN: | 0303-8467 |
| DOI: | 10.1016/j.clineuro.2018.09.034 |
| Popis: | To investigate the clinical characteristics and surgical outcomes of patients with cervical spondylotic myelopathy (CSM) and prior cerebral infarction (CI); to identify whether "prior CI" correlates with poor surgical outcomes.Twenty-two patients with CSM and prior CI were retrospectively reviewed and included as the CI group while 100 CSM patients without CI were included as the control group (matched for gender, age, symptom duration and surgical approach). Extensive demographic and surgery-related data for patients in both groups were collected and compared. Multivariate logistic regression analysis was performed to assess all potential factors affecting surgical outcomes.Compared to the control group, the CI group had the following: significantly higher percentages of hypertension, "progressive myelopathy", "rapid progressive myelopathy" and "intramedullary T2-weighted hyperintensity on MRI"; lower mean "preoperative mJOA score" and "postoperative mJOA score"; higher percentages of "preoperative mJOA score ≤11″ and "recovery rate of mJOA score50%". In the CI group, 14 patients had CI within 6 months before CSM, and their percentage of "rapid progressive myelopathy" was higher than that of patients who had CI over 6 months before CSM. Logistic regression analysis showed that smoking, "symptom duration ≥12 months", "T2-weighted hyperintensity" and "prior CI" correlated with poor surgical outcome.Rapid progressive myelopathy with advanced neurological impairment and "intramedullary T2-weighted hyperintensity" are common in patients with CSM and prior CI. Surgical outcomes in these patients are poorer than those of ordinary CSM patients. "Prior CI" is a risk factor for predicting poor surgical outcomes. |
| Databáze: | OpenAIRE |
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