Cervical Spondylotic Myelopathy (CSM) is a debilitating condition that can lead to significant neurological problems if left undiagnosed and untreated. Early diagnosis and subsequent surgical intervention are known to improve patient outcomes. However, many patients experiencing symptoms indicative of CSM often undergo prolonged periods of investigation and treatment by community-based physicians before receiving an accurate diagnosis. A recent retrospective study delved into the timeframe and processes involved in diagnosing CSM within community healthcare settings, revealing concerning delays and highlighting the pivotal role of primary care doctors.
This study meticulously reviewed the medical records of 42 patients who underwent surgery for CSM at a tertiary hospital. The research focused on gathering data related to patient demographics, presenting symptoms, the duration from symptom onset to diagnosis, the specialties of physicians involved in the diagnostic journey, the number of consultations required, and the patient’s neurological status before surgery.
The findings revealed a significant average delay of 2.2 ± 2.3 years between the onset of symptoms and a confirmed CSM diagnosis. Alarmingly, the vast majority of patients (90.4%) initially consulted either a family practitioner (69%) or an orthopedic surgeon (21.4%) for their symptoms. In contrast, only a small fraction (9.6%) initially sought care from other sources such as emergency departments. Interestingly, the diagnosis of CSM was most frequently established by neurosurgeons (38.1%) and neurologists (28.6%), with orthopedic surgeons (19%) and family physicians (4.8%) diagnosing the condition less often.
These results underscore a critical issue: the diagnosis of CSM is frequently delayed within community healthcare settings, leading to delayed referrals for necessary surgical treatment. To mitigate the risk of irreversible neurological sequelae, it is imperative that family practitioners and community-based orthopedic surgeons maintain a heightened awareness and suspicion for CSM when patients present with relevant symptoms. Improving the diagnostic acumen of primary care doctors is crucial for ensuring timely intervention and better outcomes for individuals suffering from Cervical Spondylotic Myelopathy.
