Factors affecting delay in diagnosis and surgery of patients presenting with typical signs and symptoms of cervical spondolytic myelopathy in rural population

Abstract

Background
Cervical spondylotic myelopathy (CSM) can be broadly defined as symptomatic dysfunction of the cervical spinal cord caused by degenerative changes of the bony and ligamentous spine. Cervical spondylotic myelopathy is a neurodegenerative condition found in old age patients. The objective of this study is to assess the factors causing delay in diagnosis and surgery for patients presenting with signs and symptoms of CSM in rural population.
Method
A retrospective study of 62 patients who have undergone surgery for CSM at the department of Neurosurgery in Saveetha Medical College and Hospital during the period December 2014 to December 2018 is done. Delay in diagnosis of the condition is analysed in terms of patient related factors and physician related factors. Delay in surgery is analysed in terms of logistical, financial and personal factors.
Results
The study demonstrates the factors causing delay in diagnosis and surgery in rural population and it’s impact on quality of life and neurological recovery following surgery. The patients with delay in diagnosis showed more serious symptoms at time of presentation and hence had some persistent complaints after surgery. The main reason for delay in diagnosis were either due to the patients immediate complaint wasn’t severe or patients not consulting concerned specialist. The reason for delay in surgery was mostly due to the financial issues in patients’ family.
Conclusion
There is a considerable difference in the nurick grade between the patients with and without delay during time of diagnosis and surgery. Patients without any delay had better prognosis. Hence it’s necessary to address these factors in a rural population.