Postoperative assessment of cervical muscle morphology, strength, and functional outcomes in patients with degenerative cervical myelopathy
Bibliographic record
Abstract
Introduction Decompressive surgery is considered a practical option for patients with progressive degenerative cervical myelopathy (DCM), nearly 40% of patients with moderate and severe DCM report partial recovery post-surgery (e.g., <50% improvement). Research question To examine the impact of decompression surgery on cervical muscle morphology and strength in DCM patients and the relationship between preoperative muscle conditions and postoperative outcomes. Material and methods A total of 10 DCM patients underwent surgery and were followed for 2 years. Among 10 patients, 7 underwent posterior fusion surgery, and 3 underwent anterior cervical discectomy and fusion (ACDF). Cervical muscle strength and MRI measurements were taken before and after surgery. Metrics included cross-sectional area (CSA), functional CSA (FCSA), fatty infiltration, and asymmetry of multifidus and semispinalis cervicis (MF + Scer) muscles. Functional outcomes were assessed using the modified Japanese Orthopedic Association, Neck Disability Index, and SF−12 health survey post-surgery. Results No significant differences in isometric cervical muscle strength were found between the ACDF and posterior fusion groups at the two-year follow-up. Posterior fusion resulted in decreased MF + Scer muscle CSA (p = 0.01), FCSA (p = 0.027), and increased asymmetry (p = 0.003). The entire cervical extensor muscle CSA also decreased (p < 0.03) with posterior fusion. ACDF led to decreased CSA (p = 0.001) and FCSA (p < 0.001) of all cervical muscles. No significant correlations were observed between pre-surgery muscle measures and functional score changes in posterior fusion. Conclusion Contrary to our hypothesis, cervical muscle strength did not improve two years post-surgery in either surgical group. Additionally, no significant correlations were observed between pre-surgical muscle strength or fat infiltration and postoperative functional outcomes. Posterior fusion surgery had a more pronounced effect on cervical musculature compared to ACDF, with greater reductions in muscle CSA and increases in asymmetry.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".