Predictive Factors for Postoperative Outcomes of Cervical Spondylotic Myelopathy in Individuals With Cerebral Palsy

Abstract

Study Design Retrospective cohort study.Objectives This study aimed to identify factors influencing postoperative outcomes of cervical spondylotic myelopathy (CSM) in individuals with cerebral palsy (CP).Methods Data from admitted individuals were retrospectively reviewed. Individuals whose modified Barthel index score, assessed at least 6 months after surgery, declined by 1 or more grades compared to their preoperative score were classified into the poor outcome (PO) group. Multivariate logistic regression analysis was performed to assess risk factors for poor postoperative outcomes.Results Of the 73 participants, 15 were in the PO group and 58 in the non-PO group. Duration (OR 1.99, 95% CI 1.25-3.65, P = .01), signal change grade 2 (OR 10.44, 95% CI 1.32-118.01, P = .034), and spinal cord compression ratio, M2 (OR 0.85, 95% CI, 0.73-0.96, P = .02) on preoperative MRI were identified as significant factors associated with the risk of poor postoperative outcomes. Based on the receiver operating characteristic curve analysis, the cutoff values for duration and cord compression metric were determined as 2 years (AUC = 0.689, 95% CI 0.532-0.845) and 76.2% (AUC = 0.841, 95% CI 0.696-0.987), respectively.Conclusions This study identified key predictors of poor postoperative outcomes in individuals with CP undergoing surgery for CSM. Symptom duration exceeding 2 years, signal change grade 2, and spinal cord compression ratio below 76.2% on preoperative MRI were found to be predictors of poor outcome. These results underscore the importance of early intervention and detailed preoperative radiological assessment to improve surgical outcomes in this population.