Study of clinical outcome following cervical spine surgery: prognostic indicators

Abstract

Background: Cervical spine surgeries done through anterior approach and posterior approach. Anterior approach is preferred in degenerative conditions and cervical spine injury. Posterior approach preferred in pathological conditions like intra dural extra tumor. Our study is to analyse the functional outcome and recovery of patients who undergone cervical spine surgeries by anterior cervical discectomy and fusion (ACDF) by bone graft with or without instrumentation, anterior cervical decompression by corpectomy and fusion and posterior cervical decompression by laminectomy.

Methods: This cross-sectional study contains patients admitted in Surgery Department, Gandhi Medical College and Hamidia Hospital, Bhopal between July 2017 to April 2019 with degenerative disease/trauma/pathological (tumor) having neurological deficit or not, to know the clinical outcome after cervical spine surgeries anterior approach and posterior approach after approval from ethical committee.

Results: In 70 cases of study 09 patients had mild preoperative neurology score (15-17) in which 3 patients had no improvement after 6 months and 06 patients improved (normal function). 39 patients had moderate preoperative neurology score (12-14) in which 28 patients improved with moderate to mild score and 03 patients remain same (no improvement). 03 patients improved after 1 year with mild score. 22 patients had severe preoperative neurology score (0-11) in which 05 cases improved with severe to moderate score and 05 cases improved with severe to mild score. These 05 cases improved with mild score after 1 year.

Conclusions: Anterior approach is better than posterior approach in our study which is comparable with existing studies in terms of hospital stay, neurological recovery and final outcome.