Introduction:. Cervical spondylotic myelopathy (CSM) is a degenerative condition that results in a non-traumatic, progressive and chronic compression of the cervical spinal cord. Surgery is indicated for patients with moderate to severe myelopathy or progressive myelopathy. Literature shows that decompressive surgery halts progression of the condition. We undertook this study to see if there is a worthwhile improvement in function in patients who had spine decompression for cervical spondylotic myelopathy. Material and Method:. From a retrospective review of our medical records, a total of 61 patients had decompressive surgery for cervical myelopathy during the period between January 2008 and January 2014. 11 Patients were excluded because their cervical myelopathy was due to compression from tuberculosis or a tumour. 33 patients had incomplete records. We are reporting on the 17 patients who had complete records. From the patients' notes we recorded the detailed preoperative neurologic examination usually done for these patients in our clinic. This was compared to the neurological examination done at 6 months, 12 months and at more than 2 years follow-up. Where this examination was not adequate, patients were called in for the neurologic examination. Results:. 13 Patients had a Nurick grading of 3 and above pre-operatively and 16 had a Ranawat classification of IIIA and above preoperatively. Post-operatively 14 patients had a Nurick grading of 1 or 0 and 15 had a Ranawat classification of II or I. There was also improvement of the physical signs that are diagnostic of myelopathy. The results were subjected to statistical analysis, but this was not conclusive because of the small numbers. Conclusion:. Decompressive surgery in this small series does not only stop progression of the myelopathy, but also improves neurologic function

Introduction. MRI signal changes are commonly found with myelopathy. The clinical significance of these signal changes in myelopathic patients remains debated. The purpose of this study was to perform a meta-analysis of the data to determine the effect of MRI signal change on pre-operative and post-operative Japanese Orthopaedic Association (JOA) scores and on recovery rate following surgery. Methods. A comprehensive review of the literature was performed to identify all published studies that provided data on the presence of MRI signal change as well as JOA scores in patients with cervical spondylotic myelopathy. Data was tabulated and JOA scores were normalised to the 17-point scale. T-tests were performed to determine if there were significant differences between pre-operative and post-operative JOA scores in patients with or without MRI signal change. The recovery rate was calculated for all patients undergoing surgery. T-tests were performed to determine if significant differences occurred in recovery rate in patients with or without MRI signal change. Results. 16 studies were used for the meta-analysis. Total sample included 886 patients: 659 with signal change, and 227 without signal change. The pre-operative and post-operative JOA scores and the recovery rates were significantly better in patients without MRI signal changes (p< 0.05). The mean pre-operative JOA scores were 10.63 and 11.37 for patients with and without MRI signal changes, respectively. The mean post-operative JOA scores were 13.37 and 14.19 for patients with and without MRI signal changes, respectively. The mean recovery rates were 43.87% and 49.31% for patients with and without MRI signal change, respectively. Conclusion. Meta-analysis revealed statistically better pre-operative and post-operative JOA scores and recovery rates following surgery in myelopathic patients without signal change. While the data were statistically significant, the clinical significance of the differences might be less due to the relatively small differences in actual values