Cervical Decompression for Myelopathy in a Resource-Poor Region: Initial Experience.
Omotayo A Ojo1, Chibuikem A Ikwuegbuenyi2
1Department of Surgery, College of Medicine of University of Lagos, Lagos, Nigeria.
World Neurosurgery
|May 16, 2020
Summary
Surgical decompression for cervical myelopathy in a resource-poor region yielded outcomes comparable to well-established centers. Despite challenges like poverty and late presentation, safe and effective spine care is achievable.
Area of Science:
- Neurosurgery
- Spine Surgery
- Global Health
Background:
- Cervical myelopathy presents significant challenges in resource-limited settings.
- Documenting initial experiences with cervical decompression is crucial for improving care.
Purpose of the Study:
- To evaluate the initial experience and challenges of performing cervical decompression surgery in a resource-poor region.
- To assess surgical outcomes for cervical myelopathy in a low-resource environment.
Main Methods:
- Prospective documentation of 43 patients undergoing cervical decompression for myelopathy.
- Preoperative and postoperative (6 weeks, 6 months) assessments using the Nurick score.
- Detailed recording of surgical procedures and patient demographics.
Main Results:
- Significant improvement in Nurick scores for 97.6% of patients (P < 0.001).
- Average Nurick score improved from 3.2 preoperatively to 1.14 at 6 months postoperatively.
- Both early and late presentation groups showed substantial postoperative improvement.
Conclusions:
- Cervical decompression surgery in resource-poor settings can achieve outcomes similar to high-resource centers.
- Challenges including poverty and limited resources can be overcome to provide safe spine care.
- Establishing a functional spine unit in underserved regions is feasible.
