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IMPACT OF SURGICAL TREATMENT ON THE GAIT OF PATIENTS WITH CERVICAL MYELOPATHY

IMPACTO DO TRATAMENTO CIRURGICO NA MARCHA DE PACIENTES PORTADORES DE MIELOPATIA CERVICAL

IMPACTO DEL TRATAMIENTO QUIRÚRGICO EN LA MARCHA DE PACIENTES CON MIELOPATÍA CERVICAL

ABSTRACT

Objective:

To analyze the impact of surgery on gait characteristics of individuals with Cervical Spondylotic Myelopathy (CSM) after one month of the procedure. Methods: Observational, cohort type study, with a quantitative analysis approach. Two assessments were performed, the first one week before surgery and the second 30 days after the decompression procedure. The following space-time variables were analyzed: steps per minute, step length, cycle time, speed, steps per minute, support time, swing time, step time. The kinematic variables obtained were analyzed by Gait Profile Score (GPS) and Movement Analysis Profile (MAP). Results: comparing pre and postoperative values, there was a decrease in the number of steps per minute (p=0.006), an increase in support time (p=0.011) and an increase in cycle time (p=0.004). Other variables did not present statistically significant differences. The patients’ total GPS average in the pre-surgery assessment was 10.41 and 1 month after the procedure, an average of 10.56 was obtained, which does not characterize a statistical difference between the assessments. When establishing a comparison between the two assessments specifically on each joint movement of the lower limbs using the MAP, it was observed that the obliquity and rotation of the pelvis showed some improvement immediately after the surgical procedure. Knee flexion and extension were significantly (p=0.018) more compromised after the procedure when compared to the value of the same population before surgery. Conclusion: the preliminary analysis of the gait of these patients after one month of intervention did not show immediate benefits of the procedure. Level of Evidence II; Therapeutic studies - Investigation of treatment outcomes.

Keywords:
Myelopathy; Decompression; Gait Analysis; Surgery

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