Quantitative assessment of cervical spondylotic myelopathy by a simple walking test

Abstract

Background: We developed a 30 m walking test as a quantifiable measure of severity of cervical spondylotic myelopathy (CSM), which will be of use in determining the effects of decompressive surgical treatment.

Methods: Preoperative measurements were made in 41 patients with CSM of 30 m walking times, number of steps taken over this distance, myelopathy disability index (MDI), and Nurick scores. The walking factors were compared with a similar number of age-matched and sex-matched controls. The individuals in the study were patients with CSM and no other relevant pathology consecutively referred for decompressive surgery to the National Hospital for Neurology and Neurosurgery.

Findings: Both walking time and the number of steps taken were significantly worse in pre-operative patients than in controls. The walking data were highly reproducible over three trials. Postoperatively, there was a significant improvement in walking time (p=0.0018) and number of steps taken (p=5.87 x 10(-6)). Only two of 41 patients were worse postoperatively. There was also a significant improvement in MDI (two-tailed Wilcoxon, related samples; p<0.0001) and Nurick scores (two-tailed Wilcoxon p<0.0001) postoperatively. The preoperative and postoperative walking scores were significantly and equally correlated with the MDI and Nurick scores.

Interpretation: Timed walks are an easily performed, quantitative, and valid means of assessing CSM and the effects of surgery.