Bikram Keshari KarAIIMS, Raipur, India
Title: Cervical Spondylotic Myelopathy; an innovative approach to guide the surgeon
Introduction : cervical spondylotic myelopathy (CSM) refers to the impaired function of spinal cord caused by degenerative changes of discs and facet joints in the cervical spine . when natural history of the disease is analysed , it is difficult to say that surgical treatment is the gold standard treatment modality for this condition due to lack of sufficient randomized control trial .
Methods: we could follow 53 cases (M-36 , F-17 ) of CSM between the age group of 20 to 70 years , most of them who had been operated in last 5 years with an average follow up of 3.8 years , have been analysed . Decompression with or without stabilization was the procedure in all cases . All cases of nuric’s grade 1- 4had been operated . A new score (odishi score ) has been framed after subjective questioners and objective assessment.
Results : 5 out of 53 (10%) had a deterioration of sign and symptoms out of them 4 cases are nuric’s grade 5 pre study. 20 (37.7%) cases admitted that they feel much better relative to pre op status but there was little / no improvement of signs . 28 (52%) cases showed improvement of signs and symptoms .
Summary : With the above findings , CSM cases are to be treated surgically if there is substantial compression of spinal cord and signal changes in MRI . Proper counselling is an essential part of treatment . Disease in advanced stage may not improve , may worsen subjected to the preexisting comorbidity and wholesome care given to patient .
To be updated