• Anoushka Singh, David Choi, and Alan Crockard.
• Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
• Spine. 2009 May 20;34(12):1296-300.

Study DesignRetrospective case-control study.ObjectiveTo study the role of surgical decompression in cervical spondylotic myelopathy (CSM).Summary Of Background DataFifty patients who received surgery, and 34 patients with myelopathy who were offered surgery but declined, or were not medically fit for surgery.MethodsWe studied the role of surgical decompression in CSM by using a validated 30-m walking test in a group of patients to assess severity before surgery and at regular intervals over the following 3 years after surgery. Such patients were compared with a matched group of control patients with myelopathy but who did not undergo surgery.ResultsThe walking data indicated a lasting benefit from surgery for at least 3 years after surgery. Patients gained a significant recovery of function which was maintained. In contrast, unoperated patients continued to deteriorate. More benefit was surprisingly seen when surgery was performed in older patients or with worse myelopathy.ConclusionSurgical decompression is beneficial in the treatment of CSM. Improvements were generally seen by 6 months from operation. Older patients and greater degrees of myelopathy were not associated with a worse outcome, suggesting surgery should not necessarily be discouraged in such patients.

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