International Clinical Neuroscience Journal

Vol. 12 No. Continuous (2025)

Clinical Trajectories in Traumatic and Non-Traumatic Cervical Spondylotic Myelopathy: A Retrospective Cohort Study and Cluster Analysis to Guide Surgical Decision-Making

International Clinical Neuroscience Journal, Vol. 12 No. Continuous (2025), 25 January 2026 , Page e2
https://doi.org/10.22037/icnj.v12i1.48691

Abstract

Background: Cervical spondylotic myelopathy (CSM) stems from either chronic degenerative changes or traumatic mechanisms. Distinguishing between these etiologies is crucial, yet identifying which patients benefit most from surgery remains challenging. This study aims to evaluate how trauma history, spinal alignment, and patient profiling influence clinical outcomes.

Methods: A retrospective cohort study was conducted on 153 patients treated at the “Ospedale dell’Angelo” (Venice, Italy). Patients were assessed using the modified Japanese Orthopedic Association (mJOA) score. Variables included trauma history, spinal alignment (Cervical Lordosis, SVA, T1 Slope), and ASA score. Statistical analysis employed linear regression and K-means cluster analysis to identify homogeneous patient profiles.

Results: Patients with a history of mild trauma showed a trend toward greater improvement compared to non-traumatic cases (mJOA improvement: +1.61 vs +0.33, p=0.074). Surprisingly, patients with straight spinal alignment achieved higher recovery (+1.29 points) than those in the kyphotic (-0.08) or lordotic (+0.15) groups. Cluster analysis identified a specific subgroup of non-surgical trauma patients who achieved remarkable recovery (+5.00 points) without intervention.

Conclusion: Trauma history acts as a potential catalyst for neurological recovery. While surgery remains the standard for unstable cases, our data suggest that a neutral (straight) alignment is associated with favorable outcomes, and that a subset of trauma patients can recover significantly with conservative management.

Keywords:
  • Cervical myelopathy; surgical outcomes; trauma; spinal alignment; patient selection

How to Cite

1.
Guarrera B, Todoverto M, Rapisarda S, Ceccaroni Y. Clinical Trajectories in Traumatic and Non-Traumatic Cervical Spondylotic Myelopathy: A Retrospective Cohort Study and Cluster Analysis to Guide Surgical Decision-Making. Int Clin Neurosci J [Internet]. 2026 Feb. 6 [cited 2026 Jul. 5];12(Continuous):e2. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/48691

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