Virtual Conference
Bikram Keshari Kar

Bikram Keshari Kar

AIIMS, 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