Serum Interleukin-10 And Clinical Outcomes After Anterior Versus Posterior Cervical Decompression

Abstract

Surgical decompression is the definitive treatment for cervical spondylotic myelopathy (CSM), yet functional recovery varies widely between patients undergoing anatomically adequate procedures. Interleukin-10 (IL-10), the principal anti-inflammatory cytokine, has been proposed as a determinant of this variability. This prospective cohort study enrolled 48 adults with CSM who underwent decompression at H. Adam Malik General Hospital through an anterior (n = 11) or posterior (n = 37) approach. Serum IL-10 was quantified by ELISA within 24 hours before surgery and 24 to 48 hours afterwards. Pain was graded with the visual analogue scale (VAS) and neurological status with the ASIA Impairment Scale (AIS) and the modified Japanese Orthopaedic Association (mJOA) score. Serum IL-10 rose roughly fourfold after surgery in both groups (anterior 1.55 to 5.53 pg/mL; posterior 1.66 to 5.99 pg/mL; both p < 0.001), and VAS fell significantly in both. Postoperative IL-10, VAS and neurological grade did not differ between approaches (p = 0.404, 0.217 and 0.694). Across the whole cohort, postoperative IL-10 correlated inversely with VAS (r = -0.308; p = 0.033) and directly with mJOA/AIS grade (r = 0.327; p = 0.023). The magnitude of the anti-inflammatory response, rather than the surgical corridor, tracked early postoperative status.