OPERATIVE OUTCOME OF DEGENERATIVE CERVICAL MYELOPATHY AND RADICULOPATHY
Journal Title: IJSR-International Journal Of Scientific Research - Year 2017, Vol 6, Issue 10
Abstract
Recovery from cervical spondylitic neurological deficit occurs rapidly following first 3 months of decompression surgery and stabilizes thereafter till 6 to 9 months of surgery. Rehabilitation should begin early to optimize this neurological recovery. Severe deficit seems to follow the same process and levels off at a lower neurological level. Exploration and follow-up of these patients requires refining more specific assessment scales than the JOA score, using quantifiable and reliable criteria. For now, evaluation of neurological recovery should preferentially take into account the absolute JOA score rather than the Hirabayashi neurological recovery rate, which is poorly adapted to evaluating patient progression. Anterior cervical discectomy with fusion for 1-2 levels has given good results than posterior laminectomy for 3 or more levels. Cervical radiculopathy alone has good recovery results after decompression surgery than myelopathy or myelopathy with radiculopathy. Duration of symptoms preoperatively, age at presentation, number of levels involved affects the recovery. They are negatively correlated with recovery. Sex of the patient and level of involvement has no correlation with recovery pattern. Severe neurodeficit at presentation also follows the same pattern of recovery, but attains lower JOA score at 9 months than patients with less neurodeficit at presentation. ODI score recovery rate also follows the same pattern of functional improvement and parallels to JOA recovery rate. Radicular pain relief occurs earlier than neck pain as measured by visual analogue scale. Based on this short to medium term study, we found that the results of surgery for cervical spondylotic myelopathy are excellent. The best neurological and functional recovery is seen in patients with mild to moderate functional disability at the time of surgery.
Authors and Affiliations
DR ATUL K PATIL, DR VIKRAM KHANNA
Keywords
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