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Hospital Eugenio EspejoCervical Myelopathy

DR Edgar CardenasResidente Neurocirugia

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Question 1 : Cervical Myelopathy = spinal cordcompression = involvement of medullary tracts.

 Anatomy of medullary tracts?

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Question 2 : Clinical evalutation of spinal cordcompression (cervical myelopathy) ?

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 Japanese Orthopedic Association Score (JOA)

Criterion Points

Motor function Paralysis

!pper e"tre#ity $ine #otor function #assively decreased % $ine #otor function decelerated & Discreet 'ea(ness in hands or pro"i#al ar# ) Nor#al function *

Motor function !na+le to 'al(

,o'er e"tre#ity Need 'al(ing aid on -at -oor % Need handrail on stairs & .+le to 'al( 'ithout 'al(ing aid/ +ut inade0uate ) Nor#al function *

1ensory!pper e"tre#ity2lo'er e"tre#ity2trun(

.pparent sensory loss  Mini#al sensory loss % Nor#al function &

3ladder function !rinary retention  1evere dysfunction % Mild dysfunction & Nor#al function )

Scoring Method and Interpretetion 4otal score 5678 4he lo'er the score the #ore severe the de9cits8Nor#al function ; 7<rade : %6*<rade %: 6<rade &: 567>eight of the criterion in percentage of 7 points: upper e"tre#ity%&8*?@ lo'er e"tre#ity %&8*?@ sensory & A 8? Btotal: &*8)?@+ladder and +o'el function 78?

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ASIA SCORE for Spine Injur

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Question ! : Cervical Myelopathy % timin$ ofdia$nosis?

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Question " : &vidence for sur$ical treatment?

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Question # ' &vidence for early sur$ery?

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Question $ : Pro$nostic factors?

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Question % : Pro$nostic studies?

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Question & : "ur$ical approaches?

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Question ' : etter results = ventral or dorsalapproach?

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Question 1 : Moridity $reater *ith ventral ordorsal approach?

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