• Anant Mehrotra, Janmejay Jamdar, Pradeep Sharma, Chaitanya Godbole, Suyash Singh, Kuntal Kanti Das, Abhai Verma, Kamlesh Singh Bhaisora, Jayesh Sardhara, Awadhesh Kumar Jaiswal, Rabi Narayan Sahu, Arun Kumar Srivastava, Sanjay Behari, and Raj Kumar.
• Department of Neurosurgery, SGPGIMS, Raibareilly Road, Lucknow, UP, 226014, India. dranantmehrotra@gmail.com.
• Eur Spine J. 2017 Sep 1; 26 (9): 2318-2323.

PurposeIdentify factors affecting constipation and post surgical improvement in patients of myelopathy.MethodsSixty-four patients with myelopathy due to extradural spine pathologies (47 cervical; 17 thoracic spine, male:female-5.4:1 with mean age 46.16) underwent evaluation including Bristol stool scale (BSS), PFT and uroflowmetry. All cases were evaluated by gastroenterologist to rule out any intrinsic bowel disease. Chi-square test, Kruskal-Wallis/Mann-Whitney U test and Wilcoxon signed rank test were employed to ascertain statistical significance.ResultsThe presence of constipation was associated with male sex (p = 0.01), degree of constipation with duration bladder symptoms (p = 0.008) and numbness (p = 0.04). The improvement in BSS after surgery (p = 0.006) was associated with local pain (p = 0.02), duration of weakness (p = 0.04) and overall symptoms (p = 0.01), also with pulmonary function tests (p = 0.002) and pre-operative Nurick's grade (p = 0.01).ConclusionConstipation is a myelopathic symptom as it is relieved by cord decompression and the gender, PFT and the duration of symptoms play an important role in defining constipation and expected improvement in these patients.

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