Clinico-radiological Prognostic Indicators of Surgical Outcomes in Cervical Spondylotic Myelopathy

Background Cervical spondylotic myelopathy (CSM), a degenerative condition of the cervical spine, has the potential to cause catastrophic and irreversible neurological impairment. In this study, an attempt was made to assess the surgical outcomes in CSM patients and evaluate the associated clinical and radiological prognostic factors impacting the outcome. Methodology This study was conducted between September 2022 and August 2024 in the Department of Neurosurgery of a tertiary-level hospital in Bhubaneswar among admitted patients aged 18 to 70 years with CSM. The functional neurological status was assessed using the Madras Institute of Neurology Prognostic Scale for cervical spondylotic myelopathy and pre- and postoperative outcome assessment by Nurick's Grading system. Data were compiled and analyzed using SPSS software version 21.0 (IBM Corp., Armonk, NY, USA). Descriptive data are represented in mean ± SD, frequencies, and percentages. The chi-square test was used for association. A p-value less than 0.05 was considered statistically significant. Results Of the 120 enrolled patients, around 76 (63.3%) were males. Outcome assessment using Nurick's grade postoperatively reported a significantly (p = 0.040) improved outcome in 53 (44.1%) patients. The improved outcome was seen more in patients with Nurick's grade 3 (28/54, 51.8%). Age less than 40 years old (p = 0.014), shorter duration of symptoms (<12 months) (p = 0.037), one level of compression (p = 0.001), and the absence of T2 intramedullary hyperintense changes (p < 0.001) significantly affected the post-surgical outcome. Conclusions A post-surgical improved outcome was seen in more than two-fifths of the patients. Age less than 40 years old, shorter duration of symptoms (<12 months), one level of compression, and the absence of T2 intramedullary hyperintense changes were the factors that significantly affected the post-surgical outcome of the patients. These clinical and radiological factors can guide the treating doctor to judge the potential of the patients and plan appropriate interventions.