Prognostication in cervical spondylotic myelopathy: Proposal for a new simple practical scoring system

Area of Science:

• Neurosurgery
• Neurology
• Orthopedics

Background:

• Preoperative outcome prediction in cervical spondylotic myelopathy (CSM) is crucial for patient management and counseling.
• Cervical spondylotic myelopathy (CSM) is a condition affecting the spinal cord in the neck.

Purpose of the Study:

• To introduce and evaluate the Madras Institute of Neurology Prognostic Scale (MINPS) for CSM.
• To provide a simple, practical tool for predicting surgical outcomes in CSM patients.

Main Methods:

• Developed a prognostic scale (MINPS) incorporating six factors: age, symptom duration, neurological disability (Nurick's grade), levels of compression, canal diameter, and cord changes.
• Assigned scores to subgroups of each factor, with a total scale range of 6 to 18.
• Validated the MINPS in 85 surgically treated CSM patients using ANOVA statistical analysis.

Main Results:

• Patients scoring 14 or higher on the MINPS generally showed improvement post-surgery.
• Patients scoring 9 or lower tended to deteriorate.
• Those with scores between 10 and 13 typically remained static.

Conclusions:

• The MINPS is a practical and accurate scale for predicting surgical outcomes in CSM.
• It utilizes readily available clinical and radiological data.
• This represents the first prognostic scale developed specifically for CSM.