Prognosis of Cervical Degenerative Myelopathy after Multilevel Anterior Cervical Discectomies and Fusion

Background: Over time, degenerative changes become more common in the cervical spine and may represent normal aging. Cervical spondylotic myelopathy (CSM) is one of the common sequelae of this degenerative process. The treatment of choice for multilevel cervical myelopathy remains under investigation. Objective: In this study, we will evaluate the outcome after multilevel anterior decompression and fusion. Patients Method: Twenty patients of cervical spondylotic myelopathy caused by multilevel cervical discs were included in this study. All cases failed to respond to conservative measures for at least two months. Patients were assessed clinically and radiologically before surgery, immediately after surgery and at the final follow up period within a minimum of three months. They were operated upon by multilevel anterior decompression and fusion using PEEK cages. Results: 90 % of our patients showed improvement, regarding their clinical symptoms, 10 % of case didn’t show any improvement. None of our cases showed deterioration than their preoperative state. Factors like pre-operative clinical state, duration of symptoms, and age were found to have a direct influence on post-operative improvement. On the other hand factors like smoking, comorbidities, pre-operative cord signal in T2WI MRI and number of levels operated wasn’t found to have influence on recovery. Conclusion: multilevel anterior decompression can reliably stop myelopathy progression in multilevel cervical myelopathy and lead to significant neurologic recovery and neck pain reduction in a majority of patients.