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  • Effect of Surgery on Gait and Proprioception in Patients with Cervical Spondylotic Myelopathy

    Final Number:

    Kingsley O. Abode-Iyamah MD; Stephanus Viljoen MD; Colleen McHenry B.Sc.; Michael Petrie B.Sc.; Kirsten Stoner M.Eng; Nicole Grosland; Nader S. Dahdaleh MD; Matthew A. Howard MD; Richard Shields PT, Ph.D

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: CSM is a common disease of aging which leads to gait instability and other dysfunction of the long tracts. Gait instability is believed to result from loss of proprioception reflex. Improvement of gait velocity is well recognized and my result in improved community ambulation.

    Methods: Fifteen patients with confirmed CSM based on clinical and radiographic findings (MRI and CT) were recruited for this prospective study. Pre and post-operative clinical scales such as nurick score and mJOA was obtained as well as demographics on each patients. Pre and post- operative Purdue pegboard test, gait kinematics and single leg squat (SLS) was also obtained on each patient.

    Results: There was improvement of the nurick and mJOA scores in pre and post-operative patient on each testing day compared to baseline. Likewise there was also improvement of the gait kinematics from pre to post-operative data. There was an improvement in the mean absolute error of the SLS representing an improvement in proprioception. Furthermore there was an inverse relationship between mean absolute error and gait velocity.

    Conclusions: There is improvement in gait kinematics following surgery for CSM. This is also reflected in the nurick and mJOA scores. SLS is an accurate measure of proprioception, which also improves following surgery for CSM. There is an inverse relationship between gait velocity and mean absolute error of SLS. This suggest that the improvement in gait velocity due to improvement in proprioception.

    Patient Care: This research improves the understanding of the pathophysiology of cervical myelopathy.

    Learning Objectives: 1. Gait instability is due to dysfunction of proprioception 2. Gait velocity is improved following surgery for CSM 3. Improvement in gait velocity is due to improved proprioception

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