# A Retrospective Analysis of Demographic, Clinical, and Postoperative Data of All Cervical Spine Surgeries Performed at a Spine Center: Our Experience of 18 Years

## TL;DR

This study analyzes 18 years of cervical spine surgeries in India, showing significant postoperative improvements and low complication rates.

## Contribution

The study provides comprehensive demographic and clinical data on cervical spine surgeries in an Indian context.

## Key findings

- Cervical spondylotic myelopathy and cervical prolapsed intervertebral disc were the most common diagnoses.
- Postoperative improvements in disability and pain scores were significant across all major pathologies.
- Perioperative complication rates were low, with dural tear being the most frequent adverse event.

## Abstract

Introduction: Degenerative cervical myelopathy (DCM) and cervical disc pathology are significant causes of neurological disability worldwide, with an estimated hospital-based incidence of DCM of approximately 7.4 per 100,000 persons per year and a population prevalence of symptomatic DCM around 2-3%, while asymptomatic spinal cord compression may be present in up to 24% of adults on imaging. Indian demographic, anatomical, and socioeconomic factors uniquely influence disease patterns and treatment outcomes, yet comprehensive local data remain scarce.

Materials and methods: This retrospective cohort study analyzed 2,667 patients who underwent cervical spine surgery at a tertiary spine center in India between January 2004 and March 2025. Demographics, diagnostic distributions, perioperative complications, and functional outcomes, including Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) scores for neck pain, were evaluated. Surgical approaches varied per pathology and surgeon preference. Statistical analyses assessed pre- and postoperative differences with paired t-tests.

Results: The cohort predominantly comprised males (2,006/2,667; 75.2%) and patients aged 45-65 years (1,266/2,667; 47.5%). Cervical spondylotic myelopathy (CSM, 1,098/2,667; 41.2%) and cervical prolapsed intervertebral disc (CPID, 670/2,667; 25.1%) were the leading diagnoses. Significant postoperative improvements were observed in ODI and NRS scores across all major pathologies; for example, CSM patients showed ODI reductions from 42 ± 10 to 16 ± 3 (p < 0.001) and NRS pain score improvement from 6.2 ± 1.1 to 2.7 ± 0.7. The perioperative complication rate was low (90/2,667; 3.38%), with dural tear as the most frequent adverse event (31/2,667; 1.16%). Other complications included fever (16/2,667; 0.6%), surgical site infection (9/2,667; 0.34%), neurological worsening (4/2,667; 0.15%), and a rare mortality rate (2/2,667; 0.08%).

Conclusions: Cervical spine surgery in this Indian cohort provides significant functional and symptomatic relief with an acceptable safety profile. The demographic and diagnostic trends mirror global patterns, adapted to regional anatomical and socioeconomic contexts. These findings support tailored surgical strategies and improved spine care delivery in India.