A study on prognostic risk factors of cervical spondylotic myelopathy Study design: A retrospective analysis

Objective: To identify the risk factors that influence the prognosis of patients with cervical spondylotic myelopathy (CSM). Methods: Clinical data were collected from 103 CSM patients treated between January 2023 and January 2024 in the Department of Orthopaedics at the First Affiliated Hospital of Nanjing Medical University. The data were retrospectively analyzed, with a one-year follow-up. Based on the Japanese Orthopaedic Association score, patients were categorized into good and poor recovery groups. Clinical characteristics, laboratory indices, and imaging findings were compared between the groups, and risk factors affecting CSM prognosis were identified. Results: A comparison between the two groups revealed that age, symptom duration, spinal cord hyperintensity length on magnetic resonance imaging, and a history of diabetes were negatively correlated with the postoperative improvement rate of CSM. Conversely, preoperative neurological symptoms, spinal cord compression ratio, and preoperative Treg cell count were significantly positively correlated with postoperative improvement rates. The stratified analysis results indicated that preoperative neurological function serves as an independent prognostic predictor, remaining unaffected by other variables. Furthermore, Treg cell count was significantly correlated with the improvement rate, particularly in elderly patients. Conclusion: The prognosis of CSM is affected by risk factors including age, preoperative JOA score, spinal cord compression ratio, lesion length, symptom duration, Treg cell count and history of diabetes.