Analysis of Cervical Sagittal Alignment After Screw-Rod Fixation

Heary, Robert F.; Choudhry, Osamah J.; Jalan, Devesh; Agarwal, Nitin

doi:10.1227/neu.0b013e31828e20ff

Cited by 5 publications

(1 citation statement)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…What is essential to preserve sagittal alignment is to only expose the upper third of the C7 vertebra, and thereby preserve the muscular attachments to the C7 spinous process as well as avoiding use of any cautery on the C7-T1 facet joints. 10 At two-year followup, he had a dramatic improvement clinically while regaining the ability to function independently. Myelopathic signs and symptoms improved and he was working out at the gym again.…”

Section: Casementioning

confidence: 97%

Cervical spondylotic myelopathy: A two decade experience

Heary

MacDowall

Agarwal

2018

The Journal of Spinal Cord Medicine

Self Cite

View full text Add to dashboard Cite

Context Cervical myelopathy occurs as a result of compression of the cervical spinal cord. Symptomatology includes, but is not limited to, pain, weakness, paresthesias, or gait/balance difficulties. Objective To present a two-decade experience with the management of cervical myelopathy. Methods Literature was reviewed to provide current guidelines for management as well as accompanying clinical presentations. Results Surgical decompression, if necessary, may be achieved from either an anterior, a posterior, or a combined anterior-posterior (AP) approach. The indications for each approach, as well as the surgical techniques, are described. Conclusion Several etiologies may lead to cord compression and cervical myelopathy. The best vector of approach with regard to anterior versus posterior surgical intervention is still under investigation. Regardless, management via surgical decompression has been demonstrated repeatedly to improve the CSM patients' quality of life.

show abstract

Section: Casementioning

confidence: 97%

Cervical spondylotic myelopathy: A two decade experience

Heary

MacDowall

Agarwal

2018

The Journal of Spinal Cord Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

Decision-making in the surgical management of degenerative cervical myelopathy

Atalay,

Christopher,

Ghogawala

2023

Degenerative Cervical Myelopathy

View full text Add to dashboard Cite

Cervical Laminectomy With or Without Lateral Mass Instrumentation

Kim

Dhillon

2019

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

Study design: Narrative review. Background: Cervical decompressive laminectomy is a common posterior approach for addressing multilevel cervical spondylotic myelopathy. However, there is a concern that cervical laminectomy can lead to kyphotic deformity with subsequent neurological decline. In this context, cervical laminectomy with fusion using lateral mass instrumentation has become increasingly utilized with the aim of reducing the risk of developing postoperative kyphotic deformity, which is thought to predispose to poorer neurological outcomes in the long term. Objective: To compare the evidence for stand-alone cervical laminectomy with laminectomy with posterior fusion in terms of clinical outcomes and the incidence of adverse events, particularly the development of postoperative cervical kyphosis. Material and Methods: Initial Medline search using MeSH terms yielded 226 articles, 23 of which were selected. An additional PubMed search and the reference list of individual papers were utilized to identify the remaining papers of relevance. Results: Cervical laminectomy both with and without fusion offers effective decompression for symptomatic multilevel cervical spondylotic myelopathy. The incidence of postlaminectomy kyphosis is lower following posterior fusion; however, there seems to be no clinical-radiologic correlation given that patients who develop postoperative kyphosis often do not progress to clinical myelopathy. Furthermore, there are specific additional risks of posterior instrumentation that need to be considered. Conclusion: In carefully selected patients with normal preoperative cervical sagittal alignment, stand-alone cervical laminectomy may offer acceptably low rates of postoperative kyphosis. In patients with preoperative loss of cervical lordosis and/or kyphosis, posterior fusion is recommended to reduce the risk of progression to postoperative kyphotic deformity, bearing in mind that radiologic evidence of kyphosis may not necessarily correlate with poorer clinical outcomes. Furthermore, the specific risks associated with posterior fusion (instrumentation failure, pseudarthrosis, infection, C5 nerve root palsy, and vertebral artery injury) need to be considered and weighed up against potential benefits.

show abstract

Analysis of Cervical Sagittal Alignment After Screw-Rod Fixation

Cited by 5 publications

References 37 publications

Cervical spondylotic myelopathy: A two decade experience

Cervical spondylotic myelopathy: A two decade experience

Decision-making in the surgical management of degenerative cervical myelopathy

Cervical Laminectomy With or Without Lateral Mass Instrumentation

Contact Info

Product

Resources

About