FUNCTIONAL ASSESSMENT IN CERVICAL MYELOPATHY, BY A TIMED WALKING TEST

Introduction: To examine if an individual’s timed walk in sufficiently reproducible to correlate with the degree of spondylitic myelopathy and if surgical decompression has measurement effect on performance. Methods: A 30mm timed walk, including a turn. The number of paces counted. Forty-one non-myelopathic individuals were obtained. There was good inter-and intra-observer reliability. Age matched with 41 patients referred to five neurosurgeons with spondylitic myelopathy were measured prior to surgery and at three, six, twelve, and twenty-four months postoperatively. Results: The mean control walking time and steps was 64.7 ± 8.4 seconds 46.9 ± 1.2 steps. The mean patients preoperative walking time and steps was 85.4 ± 11.2 seconds; 74.8 ± 5.3 steps and postoperative 64.7 ± 8.4 seconds; 63.5 ± 4.2 steps. Significant improvement following surgery (p = 0.0018 and p = 5.87 x 10 −6 respectively) and improvement maintained for at least two years after surgery. Discussion and Conclusions: The test is reproducible and reliable with good sensitivity and specificity. It shows validity and relevance when compared to other functional scales such as Myelopathy Disability and Nurick. Changes following surgery can be measured. A multi-centered trial is recommended.