Clinical and functional results in patients with cervical spondylotic myelopathy treated surgically by anterior approach in a tertiary health care center

Abstract

Objective: To evaluate the clinical and functional results in patients with cervical spondylotic myelopathy treated surgically by anterior approach in a reference center. Methods: An observational, longitudinal, analytical study was carried out. The patients were evaluated using the JOA, Nurick and SF12v2 scales at hospital admission, at 3 and 6 months after surgery, analyzing the data with the Student's T test in the IBM SPSS Statistics version 24. Results: The male sex predominated, the mean age was 61 years; the mean JOA score before surgery, at 3 and 6 months was 8, 10.9, and 11.6, respectively. The Nurick scale obtained a presurgical score, at 3 and 6 months of 2.8, 2.2, and 1.9, respectively. Regarding the quality of life (PCS), 93.3% of the patients were found to be below the mean, 2.2% in the mean, and 4.5% above the mean, while at 6 months, 91.1% of the patients were below the mean, 6.7% in the mean, and 2.2% above the mean. In the preoperative evaluation the SF 12v2 scale, 68.9% of the patients were below the mean, 2.2% in the mean, and 28.9% above the mean, being that at 6 months, 31.1% of the patients were below the mean, 15.6% in the mean, and 53.3% above the mean. A statistically significant improvement was observed with the JOA and Nurick scales from preoperative to 3 and 6 months (p<0.05) with a statistically significant difference in the mental component of quality in the same periods. Conclusions: Anterior approach decompression gives a significant clinical improvement at 3 and 6 months. However, this improvement does not correlate with the patient's perception of his or her health condition. Level of Evidence III; Case control study.