Cocaine use and surgical outcomes of cervical spondylotic myelopathy: a retrospective study

The purpose of this study was to determine the average age of individuals diagnosed with cervical spinal myelopathy who are known cocaine users vs nonusers, as well as the postoperative change in neurological condition between cocaine users and nonusers. Medical records of patients diagnosed with cervical spinal myelopathy between January 1990 and May 2006 were reviewed. Ninety-four patients were identified who underwent any surgical intervention with at least 2 years of follow-up. Group 1 comprised patients with cervical spinal myelopathy who had used cocaine, and group 2 comprised patients with cervical spinal myelopathy who had not used cocaine. All patients were clinically evaluated by the Nurick grade preoperatively and at most recent follow-up. Mean follow-up was 25 months. Mean age at presentation was 52 years (range, 44-62 years) in group 1 and 56 years (range, 42-88 years) in group 2. Average duration of symptoms prior to surgical intervention was 18.6 months in group 1 and 10 months in group 2. Average Nurick grade at presentation was 2.7 for group 1 and 2.7 for group 2. Average postoperative Nurick grade was 1.9 for group 1 and 1.33 for group 2. Change in Nurick grade was 0.8 for group 1 and 1.11 for group 2. Linear regression analysis comparing change in Nurick grade (from pre- to postoperative) was conducted, showing a correlation of -0.45 with a P value of .044. To the authors' knowledge, this is the first study demonstrating that cocaine use has an effect on postoperative improvement of neurological function in cervical spondylotic myelopathy.