Using Smartphones for Clinical Assessment in Cervical Spondylotic Myelopathy a Feasibility Study

Abstract

Background Degenerative cervical myelopathy (DCM) is characterized by progressive deterioration in spinal cord function. Its evaluation requires subjective clinical examination with wide inter-observer variability. Objective quantification of spinal cord function remains imprecise, even though validated myelopathy-grading scales have emerged and are now widely used. We created a Smartphone App with the aim of quantifying accurately and reliably spinal cord dysfunction using a 5-minute Test. Methods A patient suffering from DCM was clinically evaluated before surgery, at 3 and 6 months follow-up after surgical decompression of the cervical spinal cord. Standard scores (Nurick grade, mJOA score) were documented at these time points. A 5-minute motor and proprioceptive performance test aided by a smartphone with the N-outcome app was also performed. Results Motor performance in rapid alternating movements and finger tapping improved in correlation with improvements in standard grading scale scores. Clinical improvements were seen in maximum reflex acceleration and in Romberg testing which showed less closed/open eyes variation, suggesting pyramidal and proprioceptive function recovery. Conclusions We demonstrate that using a smartphone app as an adjunct to clinical evaluation of compressive myelopathy is feasible and potentially useful. The results correlate with the results of clinical assessment obtained by standard validated myelopathy scores.