Clinical and radiological correlates of severity and surgery-related outcome in cervical spondylosis

Object. The aim of this study was to determine if radiological features could be used to predict outcome in patients with cervical spondylotic myelopathy (CSM). Methods. The authors studied 69 patients consecutively referred to The National Hospital, Queen Square, for decompressive surgery. Data obtained from preoperative cervical spine magnetic resonance (MR) imaging studies were each analyzed on two separate occasions by two blinded radiologists. The parameters determined were signal change and the presence and severity of compression. Clinical outcome was determined by pre- and postoperative timed walks, as well as by evaluation of myelopathy disability index scores, Ranawat classification, and Nurick grades. There was good inter- and intraobserver reliability for determination of radiological data. A significant relationship was found between MR imaging signal change and surgery-related outcome, as reflected by improvement in walking parameters; however, this was confounded by the fact that signal cha...