Surgical Outcomes of Functional Balance Stability in Patients With Cervical Compressive Myelopathy

A retrospective study.

To investigate the surgical outcomes of functional balance stability in patients with cervical compressive myelopathy (CCM) using the patient-reported outcome measure (PROM) of the Falls Efficacy Scale-International (FES-I) together with an objective evaluation using the stabilometric test.

Impaired functional balance, including standing and gait instability, is a common symptom in patients with CCM. However, studies evaluating the surgical outcomes of this symptomatology using PROMs are lacking.

Data of patients who underwent decompressive surgery for CCM were retrospectively reviewed. Functional balance stability was evaluated subjectively using the FES-I instrument and objectively using a stabilometric test. Changes in these measures from baseline to 1 year postoperatively were analyzed. In addition, subgroup analyses were conducted, categorizing patients into the M (baseline FES-I score of 20-27 points) and H groups (baseline FES-I score ≥28 points).

A total of 133 patients (mean age: 65.1 y; males: 55.6%) were included in the analysis, with 43 and 90 patients assigned to the M and H groups, respectively. For the entire study population, the FES-I score significantly improved at 1 year postoperatively compared with that at baseline. Subgroup analysis showed that the 1-year postoperative FES score in the H group demonstrated a significant improvement compared with the baseline score; however, the score was still inferior to that of the M group. Regarding objective measures, significant improvements in stabilometric parameters were observed after surgery compared with those at baseline, with changes closely mirroring those of the FES-I score.

Surgery can enhance functional balance stability in the daily activities of patients with CCM. However, patients with impaired functional balance stability before surgery are likely to experience greater residual symptoms postoperatively. Therefore, to minimize postoperative sequelae, early surgical intervention is recommended when the symptoms are still mild.

Level 3.