Anterior Cervical Corpectomy and Fusion for Degenerative Cervical Spondylotic Myelopathy

Louie, Philip K.; Nemani, Venu M.; Leveque, Jean-Christophe

doi:10.1097/bsd.0000000000001410

Cited by 15 publications

(5 citation statements)

References 35 publications

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“…For example, anterior spinal column reconstruction following corpectomy used to be performed with autologous iliac crest bone. Recently, however, titanium mesh cages have become a more popular option for reconstruction [ 32 ]. In addition to changes in the procedure, cervical corpectomy has been utilized by surgeons for unique and novel indications.…”

Section: Traditional Approaches To Degenerative Disc Diseasementioning

confidence: 99%

Management Considerations for Cervical Corpectomy: Updated Indications and Future Directions

Foreman,

Foster,

Gillam

et al. 2024

Life

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Together, lower back and neck pain are among the leading causes of acquired disability worldwide and have experienced a marked increase over the past 25 years. Paralleled with the increasing aging population and the rise in chronic disease, this trend is only predicted to contribute to the growing global burden. In the context of cervical neck pain, this symptom is most often a manifestation of cervical degenerative disc disease (DDD). Traditionally, multilevel neck pain related to DDD that is recalcitrant to both physical and medical therapy can be treated with a procedure known as cervical corpectomy. Presently, there are many flavors of cervical corpectomy; however, the overarching goal is the removal of the pain-generating disc via the employment of the modern anterior approach. In this review, we will briefly detail the pathophysiological mechanism behind DDD, overview the development of the anterior approach, and discuss the current state of treatment options for said pathology. Furthermore, this review will also add to the current body of literature surrounding updated indications, surgical techniques, and patient outcomes related to cervical corpectomy. Finally, our discussion ends with highlighting the future direction of cervical corpectomy through the introduction of the “skip corpectomy” and distractable mesh cages.

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Section: Traditional Approaches To Degenerative Disc Diseasementioning

confidence: 99%

Management Considerations for Cervical Corpectomy: Updated Indications and Future Directions

Foreman,

Foster,

Gillam

et al. 2024

Life

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“…The latter may be necessary in cases of adherent OPLL where there is a high risk of massive durotomy with complete resection. 20 The interbody can be placed with a structural allograft, titanium cage, or PEEK (PolyEtherEtherKetone) cage. An anterior plating system can stabilize short segment corpectomy, such as one body.…”

Section: Surgical Managementmentioning

confidence: 99%

Cervical Myelopathy: Diagnosis and Surgical Strategies

Paschal,

Zelenty,

Sama

et al. 2023

SurgiColl

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Cervical myelopathy, a condition caused by compression of the spinal cord in the neck, is characterized by an insidious onset with slow clinical deterioration; however, it can have a rapid progression in a subset of patients, culminating in spinal cord damage/injury. In elderly patients, Cervical myelopathy is marked by multifaceted deterioration of the anatomic structures in the spinal column. Injuries can result in more acute presentations of Cervical myelopathy. Symptoms typically stem from mechanical pressure and ischemic changes exerted on the spinal cord. Common symptoms include neck pain/stiffness, spasticity/balance and gait dysfunction, loss of dexterity and fine motor movements, and upper and lower extremity dysesthesias. To diagnose accurately, a detailed history and physical examination are required. Radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are often needed, with MRI being the gold standard. Many surgical approaches exist to address spinal cord compression. The surgical approach is influenced by several factors: the exact location of cord compression (anterior/posterior), the number of levels of stenosis, overall spinal alignment, body habitus and other factors such as prior surgery.

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“…ACCF is indicated for patients with cervical spondylotic myelopathy or radiculopathy at the level of vertebral body and intervertebral disc [44,57]. Conversely, contraindications of ACCF include OPLL, trauma, tumor, previous cervical spine surgeries, or other neurologic disorders.…”

Section: Anterior Cervical Corpectomy and Fusionmentioning

confidence: 99%

Surgical Treatment of Cervical Spondylotic Myelopathy

Chen,

Zhang,

Chen

et al. 2023

IJCEMR

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Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord injury in adults. The typical symptoms of CSM are poor hand dexterity and unsteady gait pattern, which prevent patients from completing fine movements, seriously affecting their quality of life. Surgical treatment is generally recommended for patients who have moderate to severe CSM and who have received conservative treatment but whose symptoms are still progressing. However, the choice of surgical method has been controversial due to the diversity of surgical procedures of CSM. For spine surgeons, understanding the features of different procedures can greatly assist them in making clinical decisions. Based on the different approaches, operative treatments can be grouped into anterior surgery, posterior surgery, and combined anterior and posterior surgery. Anterior surgeries include anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), as well as cervical disc replacement (CDR). Posterior surgeries consist of laminectomy and laminoplasty. For patients with a complex pathophysiology and more severe CSM, combined anterior-posterior surgery, such as posterior laminoplasty or laminectomy and fusion combined with ACDF or ACCF, is often recommended. Additionally, ACDF has been applicated as the mainstay of treatment for CSM patients whose compression is confined to the disc level and has fewer than three compression segments, but the high incidence of complication should be expected, as well as the high readmission rate and additional costs. Meanwhile, as knowledge about CSM and its surgical treatment continues to expand, many trials have demonstrated the superiority of CDR in preserving the mobility of the index segments and reducing the incidence of complications. Therefore, CDR could be a better option than ACDF for patients with similar pathological changes but relatively stable cervical spine. This article summarized the pathophysiology of CSM as well as the characteristics, indications, clinical efficacy, and safety of various surgical treatments, and pays special attention to the clinical selection of CDR and ACDF, which can provide a more comprehensive reference for spine surgeons to make clinical decisions about CSM surgery.

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Anterior Cervical Corpectomy and Fusion for Degenerative Cervical Spondylotic Myelopathy

Cited by 15 publications

References 35 publications

Management Considerations for Cervical Corpectomy: Updated Indications and Future Directions

Management Considerations for Cervical Corpectomy: Updated Indications and Future Directions

Cervical Myelopathy: Diagnosis and Surgical Strategies

Surgical Treatment of Cervical Spondylotic Myelopathy

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