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Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion
Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion
- Source :
- Surgical Neurology. 64:S30-S35
- Publication Year :
- 2005
- Publisher :
- Elsevier BV, 2005.
-
Abstract
- Background Fifty-one patients with cervical spondylotic myelopathy (CSM) treated by anterior cervical corpectomy with fusion (ACWF) at our institution were included in a study during a period of 10 years to evaluate neurological, anatomical, and functional outcomes including satisfaction levels. Methods We have completed a prospective evaluation of 39 patients with spondylotic myelopathy submitted to ACWF during the period of 1989-2000. The data were analyzed for age, duration of symptoms, severity of preoperative neurological deficit, and single-level or multilevel compressive status looking for possible association with prognostic surrogate data and clinical outcome that were evaluated with the Nurick score and a survey of level of satisfaction. Results Of the 51 patients, 39 fullfilled the intended follow-up being 28 men (71.8%) and 11 women (28.2%). The average age was 63.5 years. Duration of symptoms ranged from 1 to 240 months (mean, 38.1 months). The mean preoperative Nurick scale score was 2.97; the mean postoperative score was 2.1. The most frequently involved vertebral body was C5 (71.7%). The follow-up period was longer than 18 months for all patients. Postoperative nonneurological complications occurred in 8 patients (15.6%). The mortality rate was 1.9% (n = 1). Postoperative results showed improvement in 25 patients (64.1%), no change in 13 (33.3%), and worsening in 1 (2.6%). The correlation coefficient of preoperative and postoperative Nurick scores was 0.733 (R2 = 0.53). Of the 39 patients, 31 answered the questionnaire for quality of life—19 (61.2%) were very satisfied, 6 were satisfied (19.35%), and 6 were not satisfied (19.35%). Conclusion Most patients (80.6%) were very satisfied or satisfied with the outcome and would decide again for the surgery (87%) if the results were previously known. Anterior cervical corpectomy with fusion was a reliable and rewarding procedure for CSM, with functional improvement in most patients. Excellent long-term outcome results in cervical fusion can be achieved without the use of hardware instrumentation.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Decompression
medicine.medical_treatment
Osteoarthritis
Spinal Osteophytosis
Postoperative Complications
Quality of life
Surveys and Questionnaires
Arthropathy
medicine
Humans
Prospective Studies
Corpectomy
Prospective cohort study
Aged
Aged, 80 and over
Clinical Trials as Topic
business.industry
Patient Selection
Mortality rate
Recovery of Function
Middle Aged
Decompression, Surgical
Prognosis
medicine.disease
Surgery
Clinical trial
Spinal Fusion
Treatment Outcome
Patient Satisfaction
Cervical Vertebrae
Quality of Life
Female
Neurology (clinical)
business
Spinal Cord Compression
Brazil
Subjects
Details
- ISSN :
- 00903019
- Volume :
- 64
- Database :
- OpenAIRE
- Journal :
- Surgical Neurology
- Accession number :
- edsair.doi.dedup.....a8dcecee287465709d08da400fa77094
- Full Text :
- https://doi.org/10.1016/j.surneu.2005.02.016