Cervical Degenerative Disease– An Evaluation of the Clinical and Radiological Outcomes of the Different Treatment Methodologies: A Prospective Institutional Study

Abstract

Aim: To evaluate the clinical and radiological outcomes of different surgical procedures and correlation of various modalities of treatment, including conservative management of Cervical degenerative disease. Materials and Methods: It was a Prospective Observational study conducted on 80 patients having features of Cervical Spondylotic Myelopathy (CSM) admitted in the Neurosurgery department of IGIMS Patna. Patients having features of CSM and admitted under neurosurgery department were included in the study. Patients’ detailed History and examination was done and they were asked to undergo MRI or other investigations as required. Patients then underwent preoperative workup and after surgical fitness those in need of surgery were operated either through the anterior or posterior route depending upon the site of the pathology. Patients presenting with neck pain {no neurological deficit} with no MR findings of root or cord compression were included in the group managed conservatively after ruling out other pathological causes of neck pain. Results: Mean age of 51.33 ±12.92 years. Majority of the study subjects in the present study were males (72.5%). Neck pain (82.5%) was the most common complaint followed by neck pain with radiating character (40%). The main precipitating factor of cervical degenerative disease was lifting or carrying heavy objects (83.8%). Radiological outcome showed out of 35 cases increase in diameter of spinal canal and reduction of myelopathy was seen in 88.6% (31 out of 35 cases) and 80% (28 out of 35 cases) of the patients respectively. According to Nurick’s score we found it reduces significantly in corpectomy with cage and laminectomy with lateral mass fixation (p value = 0.014 and 0.012 respectively) group. Preoperative pain score reduces significantly in all the surgical technique groups except corpectomy with grafting