Abstract
Introduction:
Cervical spondylotic myelopathy (CSM) is a degenerative condition that results in a non-traumatic, progressive and chronic compression of the cervical spinal cord.
Surgery is indicated for patients with moderate to severe myelopathy or progressive myelopathy. Literature shows that decompressive surgery halts progression of the condition. We undertook this study to see if there is a worthwhile improvement in function in patients who had spine decompression for cervical spondylotic myelopathy.
Material and Method:
From a retrospective review of our medical records, a total of 61 patients had decompressive surgery for cervical myelopathy during the period between January 2008 and January 2014. 11 Patients were excluded because their cervical myelopathy was due to compression from tuberculosis or a tumour. 33 patients had incomplete records. We are reporting on the 17 patients who had complete records.
From the patients' notes we recorded the detailed preoperative neurologic examination usually done for these patients in our clinic. This was compared to the neurological examination done at 6 months, 12 months and at more than 2 years follow-up. Where this examination was not adequate, patients were called in for the neurologic examination.
Results:
13 Patients had a Nurick grading of 3 and above pre-operatively and 16 had a Ranawat classification of IIIA and above preoperatively. Post-operatively 14 patients had a Nurick grading of 1 or 0 and 15 had a Ranawat classification of II or I. There was also improvement of the physical signs that are diagnostic of myelopathy.
The results were subjected to statistical analysis, but this was not conclusive because of the small numbers.
Conclusion:
Decompressive surgery in this small series does not only stop progression of the myelopathy, but also improves neurologic function.
