THE EFFICACY OF SURGICAL TECHNIQUES FOR CERVICAL SPONDYLOTIC MYELOPATHY ON FUNCTIONAL OUTCOME, RECOVERY AND PATIENT SATISFACTION

Abstract

Objective: Cervical spondylotic myelopathy is a neurological condition that develops due to degenerative changes of the spine resulting in compression of the spinal cord and its vascular structures. It is the most common form of spinal cord injuries in adults; however, its diagnosis is often delayed due to the insidious progression of the disease. We investigated the functional outcome, recovery and satisfaction of patients undergoing surgical treatment in our clinic. Materials and Methods: The study included patients who were operated for spinal stenosis caused by cervical spondylosis. The patient's age, sex, admission complaint, duration of complaint, comorbidities, neurological examinations and gait performances were evaluated, measured by the Nurick Scale. The spinal cord was examined with the preoperative Magnetic Resonance imaging. The operative times, surgical techniques, complications, post-discharge follow-up durations, functional outcomes and long-term complaints of the patients were analysed. We divided the patients into four groups according to the surgical technique. Results: A total of 50 patients were operated, of which 38 were males and 12 were females (M/F=3.16), with a mean age of 68.8 years. Of these patients, 24 (48%) underwent only laminectomy (group 1), six (12%) underwent laminectomy and fusion (group 2), 17 (34%) underwent corpectomy and anterior fusion (group 3) and three (6%) underwent combined surgery (group 4). Recovery was seen in 60% of all the patients, while 6% had deterioration in myelopathy. The patients in group 1 had the shortest operative time and length of hospital stay, while those in group 2 had the highest satisfaction and recovery rate (83.33%). Conclusion: Age, duration of symptoms and neurological condition at admission are the most important determinants of the response to treatment. Patients who are clinically and radiologically diagnosed should be treated with surgery as soon as possible, and restoration of cervical alignment, decompression and if necessary, fusion should be effectively performed in the surgery.