Significance of Stabilometry for Assessing Postoperative Body Sway in Patients with Cervical Myelopathy

Shinji Tanishima, Hideki Nagashima, Hiroyuki Ishii, Satoru Fukata, Toshiyuki Dokai, Taiki Murakami, Yasuo Morio, Shinji Tanishima, Hideki Nagashima, Hiroyuki Ishii, Satoru Fukata, Toshiyuki Dokai, Taiki Murakami, Yasuo Morio

Abstract

Study design: Prospective study.

Purpose: To examine the changes in body sway using stabilometry in patients who underwent cervical laminoplasty for cervical myelopathy.

Overview of literature: Although the patients of cervical myelopathy complain body sway there are few report to examine body sway objectively.

Methods: Patients who received treatment for cervical myelopathy between October 2010 and February 2013 were included. Twenty-one patients underwent cervical laminoplasty (myelopathy group). Body sway was assessed using stabilometry, wherein patients stood on a stabilometer with their eyes closed for 30 seconds. The Romberg ratio, outer peripheral area (OPA) with eyes closed (cm2), and total locus length per unit area (L/A) with eyes closed (/cm) were examined. Examinations were performed preoperatively (at baseline) and at 8 weeks postoperatively. Examination results of patients in the myelopathy group were compared with those of 17 healthy individuals (control group). Clinical symptoms were evaluated using the Japanese Orthopaedic Association scale score (JOA score) and the timed up and go (TUG) test.

Results: In the myelopathy and control groups, the mean baseline Romberg ratio, OPA, and L/A were 2.3±1.2, 8.9±5.5 cm2, and 14.2±5.3/cm and 1.4±1.0, 4.3±2.8 cm2, and 23.7±10.1/cm, respectively. Eight weeks after laminoplasty, only L/A showed significant improvement from baseline in the myelopathy group (23.2±10.1 to 16.8±7.9; p=0.03). The Romberg ratio and OPA showed improvement in the myelopathy group, but the changes were not statistically significant. JOA scores and TUG test results in this group significantly improved from baseline to 8 weeks after laminoplasty (12.7 to 13.4 and 10.8 to 8.0 seconds, respectively; both p<0.05).

Conclusions: L/A is a useful parameter for measuring body sway to assess the recovery of body sway after laminoplasty.

Keywords: Laminoplasty; Postural balance; Spinal cord diseases; Spine.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1. Patients standing on the stabilometry…
Fig. 1. Patients standing on the stabilometry platform for 30 seconds with their eyes closed.
Fig. 2. Sample stabilograms of patients in…
Fig. 2. Sample stabilograms of patients in the control and myelopathy groups. (A) Control group. (B) Myelopathy group preoperatively. (C) Myelopathy group postoperatively.
Fig. 3. Stabilogram parameters used for evaluation.…
Fig. 3. Stabilogram parameters used for evaluation. OPA, outer peripheral area with the track of the center of gravity (black arrow); Total locus length, length of the center of gravity (dashed arrow pointed blue line); L/A, total locus length/OPA; Romberg ratio, OPA (eye closed)/OPA (eye opened).
Fig. 4. A comparison of the JOA…
Fig. 4. A comparison of the JOA scores and TUG test results pre and post laminoplasty in the myelopathy group. JOA, Japanese Orthopaedic Association; TUG, timed up and go.

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