Prognostication in cervical spondylotic myelopathy: Proposal for a new simple practical scoring system

CONTEXT: The ability to preoperatively predict the outcome in cervical spondylotic myelopathy (CSM) helps in planning management and counseling the patient and family. AIMS: A simple prognostic scale, namely, the Madras Institute of Neurology Prognostic Scale (MINPS) for CSM has been proposed. SETTINGS AND DESIGN: Six well-known prognostic factors, namely, age, duration of symptoms, neurological disability (Nurick's grade), number of levels of compression, effective canal diameter, and intrinsic cord changes, have been taken into account. Each factor has been divided into three subgroups and allotted a score. The total score in this scale ranges from a maximum of 18 to a minimum of 6. MATERIALS AND METHODS: This scale has been evaluated in a group of 85 patients operated for CSM. STATISTICAL ANALYSIS USED: The usefulness of MINPS was statistically assessed using ANOVA test. RESULTS: It has been found that majority of patients with a score of 14 or more improved; those with a score of 9 or less deteriorated; those with a score between 10 and 13 remained static. CONCLUSIONS: The MINPS for CSM is a very practical scale which can be applied easily with the available clinical and radiological data, with good accuracy of outcome prediction. This is the first scale of its kind.