Measurement of outcome in patients with cervical spondylotic myelopathy treated surgically.

The objective was to establish the role of the Short Form 36 (SF 36) as an objective measure of clinical outcome in cervical spondylotic myelopathy (CSM), and took the form of a prospective observational study. Seventy patients with symptomatic CSM were treated by surgical decompression. Health status was measured pre- and 3 months postoperation using objective, validated patient completed measures. These were the SF 36, neck disability index, myelopathy disability index and analogue scores for neck pain and arm symptoms. SF 36 scores were compared with age matched control data. Twelve-month postoperative data are available in a proportion of the cohort. CSM patients have lower preoperative SF 36 scores than age-matched population controls. Comparing pre- and postoperative SF36 scores for the physical functioning domain 64% of patients improve, 23% show no change and 14% of patients continue to deteriorate (Wilcoxon P< 0.0001). These changes are replicated in other domains of the SF36 and by the other measures of outcome. The SF36 is responsive, valid, and practical. Its use for determining outcome in the surgical treatment of CSM is recommended.