Clinimetrics in cervical spondylotic myelopathy
1Akademia Wychowania Fizycznego w Katowicach i „Repty” Górnośląskie Centrum Rehabilitacji w Tarnowskich Górach (prof. dr hab., Akademia  Wychowania Fizycznego im. Jerzego Kukuczki w Katowicach)
2Śląska Wyższa Szkoła Informatyczno-Medyczna w Chorzowie
AKTUALN NEUROL 2010, 10 (2), p. 89-93
ABSTRACT

Cervical spondylotic myelopathy (CSM) is a common disease. It is caused by increasing narrowing of the spinal canal causing compression on the nerve roots and spinal cord. The first symptoms usually are: whiplash neck pain, numbness of the hands, gait disorders, sphincter dysfunction and impotence. Neurological investigation firstly shows hand paresis and muscle atrophy, later on the paralysis of the lower limbs and the neurogenic bladder dysfunction. Often, it is concluded the presence of depression. Some patients required surgical treatment. In this review article the most commonly used scales for the clinimetric evaluation of patients with CSM has been described. There is a wide range scales for the basic clinical assessment of patients with CSM. The most commonly used are: Neck Disability Index (Modified Oswestry Low Back Pain Index), Ranawat grade, Nurick scale, Cooper scale, Myelopathy Disability Index (MDI), Japanese Orthopaedic Association (JOA) score, and European Myelopathy Score (EMS). For evaluation of pain most often used is Visual Analogue Scale (VAS; Carlsson, 1983). Basic depression scale used in CSM is Hospital Anxiety and Depression Scale (Zigmond and Snaith, 1983). In assessing the patient’s autonomy in activities of daily living (called activities of daily living, ADL) still widely used is Barthel Index. The most accurate estimation of everyday functional capacity is Functional Independence Measure (FIM). For assessment of hand function test most commonly used are: Nine Peg & Hole test (Kellor, 1971) and Jebsen-Taylor Test (1969). Prabhu et al. in 2005 assessed the results of surgical treatment of CSM’s using the Rapid Hand Flick Time (RHFT). For walking quantitative tests are most commonly used transition distance of 6 meters, 10 meters, 20 meters. Nurick in the year 1972 proposed six-level scale of qualitative walking assessment in patients with CSM which is commonly used so far. Ranawat assessed gait in patients with SCI in the CSM using neurological four-level scale (1979). Since more than 50 years for patient eligibility for surgery and the outcome measure the criteria Odom’s (1958) are still used. Myelopathy Disability Index (MDI) was created in 1996 by Casey et al. as modification of Stanford Health Assessment Questionnaire (HAQ). Modified by Keller, 1993 Japanese Orthopaedic Association Cervical Spinal Myelopathy Functional Assessment Scale (mJOACSMFAS) assesses four features: hand, gait, sensory and sphincter urinary bladder.

Keywords: cervical spondylotic myelopathy (CSM), clinimetrics, outcome measure, clinical evaluation, prognosis