title: Outcome of surgical treatment of cervical spondylotic myelopathy: Experience in 120 patients.
abstract: OBJECTIVE
  To document the outcome of spinal surgery in patients of cervical spondylotic myelopathy.
  
  
  METHODS
  The quasi-experimental study was conducted at the Department of Spine Surgery at Combined Military in a tertiary care hospital in Rawalpindi from 2006 to 2013. A pre-designed proforma was used for each patient and records were kept a custom-built computer database. Neurik grading was used to assess neurological status preoperatively, at 6 months, 1 year and 2 years.
  
  
  RESULTS
  There were 120 patients with a mean age of 60.08 years (range 26-82, standard deviation 13.13). Of them 108 (90%) were males and 12 (10%) females. The preoperative neurologic status was Nurick\'s grade 0 in 6 (5%) patients There were 120, I in 9 (7.5%), II in 23 (19.16%), III in 28 (23.33%) and IV in 19 (15.83%) and V in 35 (28.16%). The spine was approached anteriorly in 48 (40%) patients and posteriorly in 72 (60%). Single level was involved in 23 (19.16), two in 30 (25%), three in 22 (18.33%) and four in 45 (37.5%) cases. Anterior cervical disc excision and fusion was done in 26 (21.67%), anterior corpectomy and fusion with bone graft or a cage in 21(17.5%) cases, laminoplasty in 9 (7.5%), laminectomy with lateral mass screw fixation with reconstruction titanium plate in 37 (30.83%) or with rod 24 (20%). In 3 (2.5%) cases only decompressive laminectomy was done. At 6 months Nurick 0 was in 26 %21.67%), I in 14 (11.67), II in 17 (14.16), III in 21 (17.5), IV in 29 (24.16%) and V in 13 (10.83). At one year Nurick grade was 0 in 38 (32.67%, I in 16 (13.33%), II in 14 (11.67), III in 15 (12.5%), IV in 23 (19.16) and V in 14 (11.67%). At the end of 2 years Neurik grade was 0 in 40 (33.33%), I in 15 (12.5%), II in 13 (10.83%), III in 16 (13.33%), IV in 22 (18.33% and V in 14 (11.67%).
  
  
  CONCLUSIONS
  Single, double and triple levels with predominantly anterior cervical spondylotic myelopathy pathology can be operated anteriorly while multi-level disease with lordotic spine should be approached posteriorly.
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Ibrahim Farooq
authors.initials: IF
authors.lastname: Pasha
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Ahmed Bilal
authors.initials: AB
authors.lastname: Khalique
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Muhammad Asad
authors.initials: MA
authors.lastname: Qureshi
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Talha
authors.affiliation: Medical Student, Allama Iqbal Medical College/Jinnah Hospital, Lahore, Pakistan.
authors.forename: Maheen
authors.initials: M
authors.lastname: Farooq
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Wasim
authors.initials: W
authors.lastname: Afzal
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Junaid
authors.initials: J
authors.lastname: Ismail
authors.affiliation: Department of Spine Surgery, CMH, Rawalpindi.
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmad
keywords: Cervical spondylotic myelopathy, CSM, Laminectomy, Spinal fusion.