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Prognostic Scale (MINPS) for Cervical Spondylotic Myelopathy (CSM)

Purpose: To evaluate a patient with cervical spondylotic myelopathy (CSM) using the Madras Institute Prognostic Scale (MINPS) of Ramesh et al.

Description

Ramesh et al developed a scoring system for patients with cervical spondylotic myelopathy (CSM). This can help to identify a patient who may benefit from surgical management. The authors are from the Madras Institute of Neurology (MIN), Madras College and Government General Hospital, and Chettinad Superspecialty Hospital in India.


 

Patient selection: cervical spondylotic myelopathy (CSM)

 

Parameters:

(1) age in years

(2) duration of symptoms in years

(3) Nurick's neurologic grade (from 0 to 5)

(4) effective canal diameter in millimeters

(5) number of levels of compression

(6) intramedullary signal change (lesion) on T2-weight MRI

 

Parameter

Finding

Points

age in years

< 40 years

3

 

40 to 60 years

2

 

> 60 years

1

duration of symptoms

< 1 year

3

 

1 to 2 years

2

 

> 2 years

1

Nurick's grade

0 to 2

3

 

3

2

 

4 or 5

1

effective canal diameter

> 11 mm

3

 

9 to 11 mm

2

 

< 9 mm

1

number of levels with compression

1

3

 

2

2

 

3 or more

1

intramedullary signal change (lesion)

None

3

 

ill-defined (Type I)

2

 

well-defined (Type 2)

1

 

total score =

= SUM(points for all 6 parameters)

 

Interpretation:

• minimum score: 6

• maximum score: 18

• The score correlates with outcome following surgery.

 

Score

Surgical Outcome

>= 14

Improved

10 to 13

Static

<= 9

Deteriorated

 


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Specialty

Objective

ICD-10