584 - Functional outcome of degenerative cervical-myelopathy operated on in the medullary compression stage

Objectives: The aim of this study was to investigate the functional outcome of DCM complicated by spinal cord compression in the short and medium term.

Design: This is a retrospective, descriptive Study conducted in a physical medicine and rehabilitation department. Patients with DCM complicated by spinal cord compression operated on between 2015 and 2023 were included. Data were collected from medical records. Functional evaluation included gait assessment, motor deficit, presence of spasticity and functional independence assessed by the functional independence measure (FIM) in the immediate postoperative period, after one month and 3 months of evolution. The overall score ranged from 18-126. Japanese Orthopaedic Association ''JOA'' score for quantifying neurological deterioration

Results: Forty patients were included, with a males predominance. The mean age at diagnosis was 56 ± 15. The reasons for preoperative consultation were motor deficits in 80% of cases, with tetraparesis in 55% and paraparesis in 20% and gait disorders in 65%. spasticity was predominantly in the lower limbs. In the immediate postoperative period, the mean FIM score was 79.5 ± 21, rising to 93 ± 22 at one month (p = 0.001) and 94 ± 10 at 3 months.

The preoperative mean JOA value was 8.30/17, corresponding to an advanced value for the spinal lamina, with repercussions on daily life. Postoperatively, the mean JOA was 7.7, rising to 9.58 at one month and 9.8 at 3 months.

At 3 months post-op, there was a significant improvement in walking: impossible in 10%, possible with assistance in 70% and possible without assistance in 20% of cases

Conclusions: DCM at a stage of spinal cord compression presents a major functional handicap, as evidenced by a low JOA score < 10. Immediate postoperative management and close follow-up can improve functional prognosis and quality of life.