Success Rate and Complications Associated with the Surgical Treatment of Cervical Spondylosis Myelopathy in Albania.

Abstract

Background: Patients suffering from cervical spondylotic myelopathy (SCM) and that do not respond to conservative treatment could benefit from anterior cervical spine surgery. However, surgical intervention is associated with increased risk of complications and therefore the decision to operate should be weighed against benefits. The purpose of this study was to describe the effectiveness and the rate of complications of anterior cervical spine surgery among CSM who do not respond to conservative treatment in Albania. 
 Material and Methods: A total of 100 CSM patients who did not respond to conservative treatment and who showed up at our Service during 2014-2019 were subjected to anterior cervical spine surgery to resolve the CSM related signs and symptoms. The success rate as well as short-term and long-term complication of surgery were evaluated and reported. 
 Results: The mean age of CSM patients (59% males) in the study was 51.5 years. One surgical procedure was employed in 90% of CSM patients whereas two procedures were necessary in the remaining 10%. The overall success rate of anterior cervical spine surgery was 70% (excellent in 40% of CSM patients and good in 30% of patients) whereas in 30% of CSM patients’ surgery did not bring any benefit or there were no changes compared to before the surgery. The overall rate of complications was 16%; no patients died following surgery. Specific complications were rare and varying from 1% of patients (Brown-Sequard syndrome, vocal cord paresis, wound infection) to 3% (subcutaneous hematoma).
 Conclusion: Anterior cervical spine surgery is associated with a relatively high success rate and a low level of post-operative complications and it might be regarded as a safe treatment among these CSM patients who do not respond to conservative treatment.