Abstrakt
Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in patients over 60 years old. Symptoms often develop gradually and insidiously and are characterized by neck stiffness, arm pain, numbness and clumsiness of hands, as well as weakness of the hands and legs frequently leading to a change in mobility.
Surgery is performed primarily to prevent the progression of symptoms but also with the aim of improving existing symptoms. Aim of our study was to assess the outcomes and potential complications of surgical decompression of cervical spondylotic myelopathy (CSM).
Prospective data was collected from 71 patients who were treated surgically for CSM over a four-year period (June 2006 to June 2010). Only patients with confirmed spondylotic cervical mmyelopathy were included in the study; those with an inflammatory, infectious or neoplastic etiology were excluded.
The Nurick scale was used as a primary outcome measure, and the improvement in upper limb function as a secondary outcome measure. Statistical significance was assessed using the paired t-test.
Our results demonstrate that the greater the preoperative disability the greater the final disability is expected to be. Cord signal change, as an indicator of the pathological severity of the disease, correlates with a worse functional outcome.
The degree of improvement postoperatively (i.e. the functional change) does not show a significant correlation with the initial preoperative status. It appears however, that there is a better chance of improvement in patients with no objectively detectable weakness or muscle wasting.
The rate of complications encountered in this series is comparable with those in the literature, which renders them valid for quoting when considering surgical treatment for CSM.