Surgical outcomes in cervical spondylotic myelopathy with severe cord compression and intramedullary signal changes: a retrospective descriptive study.

Elmalik, El Fatih Bashir; Metwaly, Laila; Mohammed, Mohammed A A · Eur J Orthop Surg Traumatol · 2026

retrospective_cohort · Level III

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Abstract

To evaluate surgical outcomes in cervical spondylotic myelopathy (CSM) with intramedullary signal changes (IMSCs) and assess the impact of preoperative severity on recovery. This retrospective study included 312 patients undergoing cervical decompression. Neurological status was assessed using the mJOA score preoperatively and at 6-12 months. A subset of 43 patients was analyzed separately for inferential statistics using chi-square testing. Severe CSM was present in 54.2% and moderate in 45.8%. Overall improvement occurred in 53.2%, with a mean mJOA increase of 2.9 points. In the subset, mean mJOA improved from 10.25 (SD 1.80) to 13.16 (SD 2.43). A significant association was found between preoperative severity and outcome (p < 0.05). Surgical decompression leads to meaningful neurological improvement, with outcomes influenced by preoperative severity.

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