European Journal of Molecular & Clinical Medicine

Abstract

Background:The aim of our study is to, Analyze the incidence, pathophysiology, clinical
features and various treatment options for cervical compressive myelopathy.Predicting
the surgical outcome in anterior cervical approach in cervical compressive myelopathy.
Materials and Methods: The present study is a prospective study comprising of 90 cases
of cervical spondylotic myelopathy. Studied over a period from September 2013 to
December 2015 in the department of neurosurgery, RMC, GGH, Kakinada. The cases
included in this study were cases of cervical spondylotic myelopathy with ventral
compression or 2 or 3 level of PIVD.
Results: The youngest patient in our study was 18 years old, whereas the eldest patient
was 70 years old. The mean age in our study was 45.7 years. The commonest clinical
presentation in our study was motor symptoms. Out of 46 grade I and II (mild) cases,
86.95% (40 cases) (10 cases) had improvement and 13.04% were remained as such
after1 month Of surgery. In moderate cases (grade III and IV) 70% cases improved,
27.5% cases remained static & 2.5%(1 case) developed Ml in post op period. In 4 severe
cases, 2 cases remained as such whereas 2 cases expired on 2ndpost operative day
because of myocardial infarction. Patients who are operated for single level lesion
showed 100% improvement after 6months followed by 2 level lesion it showed an
improvement of 74% after 6 months and 3 level lesions With 56% after 6months.
Conclusion: In cervical spondylotic myelopathy with anterior compression,
decompression by posterior surgery is ineffective as you can’t remove osteophytes more
over multilevel cervical spondylotic myelopathy is accompanied by various levels of
nerve root compression and posterior surgery is ineffective for the decompression of
nerve roots resulting in persistence of post operative symptoms.