Functional Assessment of Patients by Nurick Grading Undergoing Surgical Treatment for Cervical Myelopathy

Open Access

Abstract

Background: Cervical myelopathy is a degenerative spinal cord condition that leads to disability, and surgical decompression is the primary treatment for moderate to severe instances. This research sought to evaluate functional outcomes after surgery through Nurick grading and determine factors affecting recovery. Methods & Materials: This observational study was carried out prospectively in the Department of Neurosurgery at Dhaka Medical College Hospital from July 2023 to June 2025, involving 60 patients with cervical myelopathy who were receiving surgical decompression. Functional results were evaluated through the Nurick grading system before and after surgery at 6 months, and the data were analyzed using SPSS version 25, with p < 0.05 deemed significant. Results: The mean age of patients was 53.7 ± 11.4 years, with male predominance (60%). Most patients presented with moderate to severe disability (Nurick grade 3-4). Postoperatively, a significant improvement in functional status was observed, with mean Nurick grade improving from 3.31 ± 1.18 to 2.18 ± 1.27 (p < 0.001). Overall, 68.3% of patients showed improvement, 18.3% remained stable, and 13.4% deteriorated. One-grade improvement was most common (33.3%). A significant association was found between shorter duration of symptoms and better functional outcome (p = 0.038), with early-presenting patients showing greater recovery. Conclusion: Surgical treatment of cervical myelopathy significantly improves functional outcomes as measured by Nurick grading. Early intervention and shorter symptom duration are associated with better recovery, while advanced disease predicts poorer outcomes. These findings emphasize the importance of timely surgical management to optimize functional recovery.