Factors Affecting Surgical Outcomes in Cervical Spondylotic Myelopathy: A Retrospective Study

Abstract

Introduction:To determine the factors that may affect surgical outcomes in patients with cervical spondylotic myelopathy (CSM) by evaluating consecutive patients at our institution.Methods:Medical charts of the patients were reviewed retrospectively between 2012 and 2019. The modified Japanese Orthopedic Association scale and the postoperative functional recovery (PFR) rate were used to assess the clinical outcomes and benefits of surgical intervention. Demographics, clinical presentations, radiological variables, and surgical techniques were evaluated.Results:A total of 98 patients with CSM with a mean age of 55.4±10.7 years were included. Fifty (51.0%) patients were male. A good preoperative functional status (p=0.001, R2=0.22), female sex (p=0.008, R2=0.07), short preoperative period (p=0.007, R2=0.074), and dynamic compression on more than one dynamic magnetic resonance imaging phase (p=0.001, R2=0.115) were associated with good surgical outcomes and a higher PFR rate. No significant differences were found in the PFR rate and the complications among all surgical approaches (p>0.05).Conclusion:Demographic, clinical, and radiological factors, such as sex, preoperative functional status, preoperative clinical course, and number of dynamic compression phases, can impact surgical outcomes in CSM. Early diagnosis is very critical and extremely important in reducing persistent neurological deficits associated with CSM. We recommend early surgical intervention for patients with CSM to obtain good surgical outcomes.

Keywords

• cervical spine
• myelopathy
• spondylosis
• corpectomy
• stabilization