Proprioceptive recovery of patients with cervical myelopathy after surgical decompression.
METHODS
A prospective observational study.


OBJECTIVE
To determine whether proprioceptive deficit recovers after surgery and whether proprioceptive evaluation can predict functional outcome in cervical myelopathy patients.


BACKGROUND
Proprioceptive sensation plays an important role in smooth, coordinated movement of the limbs. Information about proprioception ascends through the dorsal columns in the spinal cord. In severe compressive myelopathy, proprioceptive ability would be reduced and could be improved after surgical decompression. However, there have been few studies concerning proprioceptive impairment in cervical myelopathy.


METHODS
The study group included 26 cervical myelopathy patients who underwent posterior surgical decompression. Knee proprioception was assessed by joint position sense, which was evaluated by measuring the error angle when the subjects tried to reproduce the predetermined angle by extension and by flexion. Proprioceptive deficit in the study group was evaluated, compared with age-matched normal subjects. Postoperative recovery and correlation to functional status was analyzed in the study group. The Japanese Orthopedic Association (JOA) scores were used for functional evaluation.


RESULTS
The error angles were significantly higher in the study group than those in the control group before surgery. All patients in the study group finally had improvement of the error angles by a year after surgery. The average of error angles in the study group was improved 2 weeks after surgery; however, no changes were observed later. There was significant correlation between the improvement rate of the error angles 2 weeks after surgery and that of the JOA scores 2 years after surgery. There were 9 patients who had worsened proprioception 2 weeks after surgery either by extension or by flexion, all of whom had poor functional outcome.


CONCLUSIONS
Knee proprioception was impaired in cervical myelopathy and recovered after surgical posterior decompression. Proprioceptive improvement at 2 weeks correlates with the degree of improvement in JOA scores at 2 years after surgery.
Takayama
Hiroyuki
H
Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Hospital, Hyogo, Japan. hytack@yahoo.co.jp
Muratsu
Hirotsugu
H
Doita
Minoru
M
Harada
Toshihiko
T
Kurosaka
Masahiro
M
Yoshiya
Shinichi
S
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011434:Proprioception; D011446:Prospective Studies; D020127:Recovery of Function; D020886:Somatosensory Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D013117:Spinal Cord Compression / Q000150:complications / Q000503:physiopathology / Q000601:surgery*