• Yasutsugu Yukawa, Fumihiko Kato, Keigo Ito, Yumiko Horie, Hiroaki Nakashima, Machino Masaaki, Zen-ya Ito, and Norimitsu Wakao.
• Department of Orthopedic Surgery, Chubu Rosai Hospital, 1-10-6 Komei, Minato-ku, Nagoya, Aichi, Japan. yukawa.ort@chubuh.rofuku.go.jp
• Spine. 2009 Jan 1; 34 (1): 82-6.

Study DesignA clinical and cohort study.ObjectiveWe developed 10 second step test as a quantifiable measure of severity in cervical compressive myelopathy. The purpose is to establish the standard value of 10 second step test and to verify its clinical effectiveness.Summary Of Background DataIn determining the severity of cervical myelopathy, the effects of surgical intervention, or the factors that influence prognosis, it is essential to have an objective and reproducible means of measuring the patient's disability. There were only a few scales to quantify the severity of cervical compressive myelopathy.MethodsOne hundred sixty-three preoperative patients with cervical compressive myelopathy and 1200 healthy volunteers were included. Three tests were performed: the number of steps in 10 seconds, number of finger grip and release (G and R) in 10 seconds and the Japanese Orthopedic Association score for cervical myelopathy (JOA score). The study population included 99 men and 64 women with a mean age of 63.3 years (range, 33-92).ResultsThe average number of steps in all patients was 10.7 +/- 5.5 before surgery whereas the average number of steps in the control was 19.6 +/- 3.5. The number of steps was significantly lower in patients than in control and decreased with age in both groups. Number of steps significantly correlated with the number of G and R, walking grade of JOA scores, and total JOA score. One hundred twenty-three patients were retested at 12 months after surgery. In this group, the average data of the step test were 10.4 +/- 5.9 before surgery, and 14.0 +/- 5.4 after surgery, showing significant postoperative improvement (P < 0.0001).ConclusionA 10 second step test is an easily performed, quantitative task, and useful in assessing the severity of CSM. Moreover, it can be used in determining the effects of decompressive surgical treatment.

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