Use of walking data in assessing operative results for cervical spondylotic myelopathy: long-term follow-up and comparison with controls.
METHODS
Retrospective case-control study.


OBJECTIVE
To study the role of surgical decompression in cervical spondylotic myelopathy (CSM).


BACKGROUND
Fifty patients who received surgery, and 34 patients with myelopathy who were offered surgery but declined, or were not medically fit for surgery.


METHODS
We studied the role of surgical decompression in CSM by using a validated 30-m walking test in a group of patients to assess severity before surgery and at regular intervals over the following 3 years after surgery. Such patients were compared with a matched group of control patients with myelopathy but who did not undergo surgery.


RESULTS
The walking data indicated a lasting benefit from surgery for at least 3 years after surgery. Patients gained a significant recovery of function which was maintained. In contrast, unoperated patients continued to deteriorate. More benefit was surprisingly seen when surgery was performed in older patients or with worse myelopathy.


CONCLUSIONS
Surgical decompression is beneficial in the treatment of CSM. Improvements were generally seen by 6 months from operation. Older patients and greater degrees of myelopathy were not associated with a worse outcome, suggesting surgery should not necessarily be discouraged in such patients.
Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Anoushka
A
Singh
David
D
Choi
Alan
A
Crockard
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D019299:Decompression, Surgical / Q000706:statistics & numerical data; D018450:Disease Progression; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D055009:Spondylosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*