title: Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy.
abstract: BACKGROUND
  Cervical spondylotic amyotrophy (CSA) is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF), and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF).
  
  
  METHODS
  28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT) and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA) scores. Patient satisfaction was also examined.
  
  
  RESULTS
  The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01). The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05). Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01). A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05).
  
  
  CONCLUSIONS
  ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Hong-Li
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Heng-Chao
authors.initials: HC
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Jian-Yuan
authors.initials: JY
authors.lastname: Jiang
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Fei-Zhou
authors.initials: FZ
authors.lastname: Lū
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Xiao-Sheng
authors.initials: XS
authors.lastname: Ma
keywords: Amyotrophy; Spine; amyotrophy; anterior cervical decompression and fusion; cervical spondylosis; cervical vertebrae; decompression; spondylitis