Effect of Surgery on Gait and Sensory Motor Performance in Patients With Cervical Spondylotic Myelopathy

Neurosurgery, 2016 · DOI: 10.1227/NEU.0000000000001267 · Published: November 1, 2016

Simple Explanation

Cervical spondylotic myelopathy (CSM) is a condition where the spinal canal narrows, compressing the spinal cord. This can lead to gait instability due to loss of leg sensory and motor functions. Surgery is a common treatment for CSM, but current methods of measuring the effectiveness of surgery are often subjective. This study explores a new, objective test called the Single Leg Squat (SLS) test. The SLS test aims to measure integrative motor sensory functions in CSM patients before and after surgery, providing a more quantitative way to assess surgical outcomes.

Study Duration

2 to 36 months symptom duration

Participants

15 patients with CSM (10 males, 5 females)

Evidence Level

Not specified

Key Findings

1
The SLS test was well tolerated by CSM patients and provided objective performance data in short testing periods.
2
Patients who underwent postoperative testing showed a decrease in mean SLS errors following surgery, suggesting improved sensory-motor control.
3
Gait velocity also improved postoperatively, and there was an inverse relationship between gait velocity change and mean absolute error in the SLS test.

Research Summary

This study investigated the feasibility of using a novel Single Leg Squat (SLS) test to measure integrative motor sensory functions in patients with CSM before and after surgery. The SLS test proved to be a practical and well-tolerated method for obtaining objective measures of leg motor sensory functions in CSM patients. The study found a relationship between postoperative increases in gait velocity and decreases in SLS errors, suggesting an improvement in sensory-motor function following surgical decompression.

Practical Implications

Objective Assessment

The SLS test offers an objective way to measure sensory-motor function in CSM patients, potentially improving the accuracy of treatment outcome assessments.

Practical Clinical Tool

The SLS test requires less space and can be implemented more efficiently than traditional gait analysis, making it a practical tool for clinical settings.

Personalized Treatment

SLS testing could help tailor surgical and rehabilitative strategies based on individual patient's sensory-motor function improvements.

Study Limitations

1
Small number of patients studied, precluding meaningful group statistical analyses.
2
Practical scheduling issues negatively impacted patient participation.
3
The study requires further validation with a larger cohort of patients in a clinic-based setting.

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