الفهرس 
Prognostic indices of surgical outcome in cervical spondylotic myelopathyprognostic indices of surgical outcome in cervical spondylotic myelopathy : A clinical prospective study
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Abstract
Background: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction. It is also the leading cause of spinal-cord-related disability in the elderly. It results from the degenerative narrowing of the spinal canal, causing spinal cord compression in a slow, progressive manner. The ability to predict the outcome preoperatively and intraoperatively will help the surgeon to identify patients with good outcome and also to plan proper rehabilitation for poor outcome groups. It also helps in counseling the patient and his family and to prepare them better for postoperative rehabilitation.Methodology: This randomized study was conducted prospectively on 40 patients with multiple level cervical spondylotic myelopathy as verified clinically and radiologically operated upon in the Neurosurgery department in Cairo University hospitals in the period from January 2019 to July 2019, fulfilling the inclusion criteria allowing one-year follow-up after surgical intervention.The patients{u2019} preoperative and final neurologic statuses were assessed using the Japan Orthopedic Association (JOA) scoring system and Nurick{u2019}s score. Prognostic factors such as sex age, duration of symptoms, and number of levels affected, signal intensity on T1-weghted and T2-weighted magnetic resonance (MR) images and intraoperative neuro-monitoring were evaluated for the prognosis for CSM. Results: The average preoperative JOA and Nurick scores were 11.23 and 3.12, respectively; the average postoperative JOA and Nurick scores were 14.1 and 1.6, respectively. The mean percentage of improvement for patients with CSM was 80%. The effects of age, sex difference, number of levels affected and signal intensity on T1- weighted and T2-weighted magnetic resonance (MR) images on prognosis were not statistically significant (p>0.05). However, duration of symptoms <1 year (p<0.05) and intraoperative neuro-monitoring were predicted to affect neurologic improvement