Operative outcomes of patients with cervical spondylotic myelopathy at Cipto Mangunkusumo National Central Hospital 2014-2016

Abstract

Introduction: Cervical spondylotic myelopathy (CSM) is the most common type of myelopathy with cervical spondylosis as the underlying disorder. To this date, there has been ongoing debate regarding operative approach in CSM treatment that there is still no established treatment proven superior one over the other. This study aims to investigate the operative outcomes of CSM. Methods: We retrospectively reviewed patients with CSM who had undergone anterior approach and posterior surgery at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, between January 2014 and December 2016. The average followup time was 13-42 months, with an average of 27 months. The clinical data of patients were observed, including age, sex, operation records, pre- and post-operative Japanese Orthopaedic Association (JOA) scores, cervical spine canal stenosis, cervical curvature, and the presence of ossification of the posterior longitudinal ligament. Results: Eight patients (6 male, 2 female) with CSM were enrolled in this study with mean age of 55.6 ± 9 years. Two patients experienced minor complication, and one patient had major complication of Frankel grade decrement and phrenic nerve paralysis that led to prolonged intensive care. The preoperative cervical JOAs of the eight patients were 11.2 ± 2.81 and post operative JOAs were 13.1 ± 3.44. (p< 0.05). Seven patients were satisfied with the outcomes of their surgery. Conclusion: A definite conclusion could not be drawn regarding the most effective surgical approach for CSM. Further studies with larger number of samples and centres are required to investigate the comparison of best treatment choice for CSM.