Factors predicting outcome after surgeries for cervical spondylotic myelopathy: A prospective study in Egypt Factors predicting outcome of cervical decompression surgery

Aim: In this study, we aimed to study factors affecting the outcome after surgeries for cervical spondylotic myelopathy (CSM). Material and Methods: A prospective study was conducted on 25 patients who had CSM surgeries at our institution. The assessment was done before the operation, at 1, 3, and 12 months after surgery using the Modified Japanese Orthopedic Association score (MJOA). Results: Patients with age >= 65 years had significantly lower MJOA scores than younger patients at 1, 3, and 12 months (P=0.007*), (P-0.007*), and (P=0.035*) respectively. Patients with diabetes had significant lower scores at 3 months (p=0.021*), and 12 months (p=0.017*). The duration of symptoms was significantly correlated with the MJOA score at 3 and 12 months (P=0.035*), (P<0.001*), respectively. There was significant positive correlation between preoperative and postoperative MJOA scores at 1, 3, and 12 months (P<0.001*), (P=0.013*), and (P=0.009*), respectively. The number of operated segments during surgery correlated with the MJOA score at 1 month (p=0.001*), and 3 months (p=0.003*). Hospital admission days after surgery were significantly con elated with MO-JAs at 1, 3, and 12 months (P<0.001*), (P=0.001*), and (P=0.004*), respectively. Preoperative somatosensory evoked potential, MRI, and mean arterial pressure at the beginning of surgery had no significant association with outcome. Discussion: Age, diabetes mellitus, duration of symptoms, severity of myelopathy, number of operated segments and duration of hospital stay after surgery are considered predictors of outcome after CSM surgeries. MRI, somatosensory evoked potentials tests, and mean arterial blood pressure at the start of surgery had no significant association with outcomes.