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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

Authors :
Flavio S. Domingues
Haroldo Chagas
Ana Luiza Vidal Fonseca
Jorge Marcondes de Souza
Antonio Aversa
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.

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