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Prognostic Factors in the Surgical Management of Cervical Spondylotic Myelopathy: Our Experience

Ishant Chaurasia , ID Chaurasia1 , Ishant Chaurasia2 , Prateek Malpani3 , Brahmanand4 , Mahim Koshariya5 , Anil Gupta6

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International Journal of Neurology and Neurosurgery 12(1):p 33-39, January-March 2020. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12120.5

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ID Chaurasia, Ishant Chaurasia, Prateek Malpani et al. Prognostic Factors in the Surgical Management of Cervical Spondylotic Myelopathy: Our Experience. Int J Neurol Neurosurg. 2020;12(1):33–39.

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Abstract

Introduction: Cervical Spondylotic Myelopathy is a common degenerative disorder of the cervical spine that can potentially cause devastating and irreversible impairment of neurological function. It’s a major source of disability in adult population leading to acquire Spinal Cord Dysfunction. The anterior cervical discectomy and fusion (ACDF) is established gold standard for degenerative cervical spine diseases. A clear overview of other surgical techniques is lacking. Cervical disc Prosthesis is not inferior to disectomy and fusion probably some superior in terms of neck pain. Material and methods: This Prospective study was done in Gandhi Medical College and Associated Hamidia Hospital Bhopal from Sep 2014 to August 2018. We included 124 patients: 89 male and 35 female. The age range is between 16 and 84 years, and means age was 58. Result: Our study suggest that patients with Nurick Grade 2 cervical spondylotic myelopathy are likely to improve from surgery and the duration of myelopathy symptoms do not have relation with the severity of the disease but is an independent prognostic factor of surgical outcome. Nurick Grade 2 cervical spondylotic myelopathic patients have good chance of resolution of symptom (p < 0.001) following surgery. Conclusion: The cervical discectomy with interbody fusion for cervical spine disease reduces pain and improve quality of the life of the patients. In light of the tremendous suffering associated with cervical spine disease, the development of new non-pharmacologic strategies to alleviate chronic pain and improve the quality of life for cervical spine disease patients deserves immediate attention and encouragement. The use of SCS has been shown to reduce opioid use and improve function in patients with other pain conditions: a very important consideration in light of the current epidemic of opioid addiction and abuse. The most important predictors of outcome were preoperative severity and duration of the symptom, also the patients selection is a key factor in determining functional outcome with good result if the pathology, clinical presentation and the radiological changes correlate.

Keywords: Cervical spine surgery; Cervical spondylotic myelopathy; Clinical outcome; Prognostic indicators.

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ID Chaurasia, Ishant Chaurasia, Prateek Malpani et al. Prognostic Factors in the Surgical Management of Cervical Spondylotic Myelopathy: Our Experience. Int J Neurol Neurosurg. 2020;12(1):33–39.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12120.5

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