Anterior cervical surgery for the treatment of cervical degenerative myelopathy

Matz, Paul G.; Holly, Langston T.; Mummaneni, Praveen V.; Anderson, Paul A.; Groff, Michael W.; Heary, Robert F.; Kaiser, Michael G.; Ryken, Timothy C.; Choudhri, Tanvir F.; Vresilovic, Edward J.; Resnick, Daniel K.

doi:10.3171/2009.3.spine08724

Cited by 48 publications

(31 citation statements)

References 7 publications

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“…[33] The Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons found that surgery for CSM leads to signifi cant improvement that is maintained for a minimum of 5 years to as long as 15 years postoperatively. [34] Another recent study has shown that surgery for CSM is associated with signifi cant functional recovery and such recovery reaches a plateau at six months after surgery. [35] However, approximately, 4% of patients show neurological deterioration after decompressive surgery.…”

Section: Prognosis Of Surgery For Cervical Spondylotic Myelopathymentioning

confidence: 99%

Surgical management of cervical spondylotic myelopathy

Muthukumar

2012

Neurol India

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Cervical spondylotic myelopathy (CSM) is emerging as the most common cause of spinal cord dysfunction in the elderly worldwide. In the past decade, our understanding of the biomechanics of the spine has improved along with advances in spinal instrumentation and this has led to significant changes in the surgical management of CSM. This review will discuss the indications, advantages and limitations of different operative approaches as well as the complications and prognosis of surgery for cervical spondylotic myelopathy. Choice of surgical approach for CSM should be based on the clinical and radiological characteristics of the individual patient and not on the preferences of the surgeon.

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Section: Prognosis Of Surgery For Cervical Spondylotic Myelopathymentioning

confidence: 99%

Surgical management of cervical spondylotic myelopathy

Muthukumar

2012

Neurol India

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“…Therefore, some surgeons would suggest early surgery for patients with CSM to ameliorate the risk of SCI. 2,9,19,21,22,24,27,33 However, there are insufficient data to correlate CSM with SCI, and whether the risk of SCI can be altered by surgical intervention remains elusive.…”

mentioning

confidence: 99%

Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study

Chen¹,

Chen³

et al. 2016

FOC

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OBJECTIVE This study aimed to estimate the risk of spinal cord injury (SCI) in patients with cervical spondylotic myelopathy (CSM) with and without ossification of posterior longitudinal ligament (OPLL). Also, the study compared the incidence rates of SCI in patients who were managed surgically and conservatively. METHODS This retrospective cohort study covering 15 years analyzed the incidence of SCI in patients with CSM. All patients, identified from the National Health Insurance Research Database, were hospitalized with the diagnosis of CSM and followed up during the study period. These patients with CSM were categorized into 4 groups according to whether they had OPLL or not and whether they received surgery or not: 1) surgically managed CSM without OPLL; 2) conservatively managed CSM without OPLL; 3) surgically managed CSM with OPLL; and 4) conservatively managed CSM with OPLL. The incidence rates of subsequent SCI in each group during follow-up were then compared. Kaplan-Meier and Cox regression analyses were performed to compare the risk of SCI between the groups. RESULTS Between January 1, 1999, and December 31, 2013, there were 17,258 patients with CSM who were followed up for 89,003.78 person-years. The overall incidence of SCI in these patients with CSM was 2.022 per 1000 person-years. Patients who had CSM with OPLL and were conservatively managed had the highest incidence of SCI, at 4.11 per 1000 person-years. Patients who had CSM with OPLL and were surgically managed had a lower incidence of SCI, at 3.69 per 1000 person-years. Patients who had CSM without OPLL and were conservatively managed had an even lower incidence of SCI, at 2.41 per 1000 person-years. Patients who had CSM without OPLL and were surgically managed had the lowest incidence of SCI, at 1.31 per 1000 person-years. The Cox regression model demonstrated that SCIs are significantly more likely to happen in male patients and in those with OPLL (HR 2.00 and 2.24, p < 0.001 and p = 0.007, respectively). Surgery could significantly lower the risk for approximately 50% of patients (HR 0.52, p < 0.001). CONCLUSIONS Patients with CSM had an overall incidence rate of SCI at approximately 0.2% per year. Male sex, the coexistence of OPLL, and conservative management are twice as likely to be associated with subsequent SCI. Surgery is therefore suggested for male patients with CSM who also have OPLL.

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“…Anterior cervical corpectomy and fusion (ACCF) is ideally suited in cases where the compressive pathology is not confined to the disc space region, and extends behind the vertebral body [56,29,34].…”

Section: Anterior Cervical Corpectomy and Fusionmentioning

confidence: 99%

Anterior Surgical Treatment of Cervical Spondylotic Myelopathy

Quinn

Kiely

Lebl

et al. 2015

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Cervical spondylotic myelopathy (CSM) is a common indication for cervical spine surgery. Surgical options include anterior, posterior, or combined procedures each with specific advantages and disadvantages. Questions/Purposes: This article will provide a description of the various anterior alternatives and discuss the available evidence used in guiding the surgical decision making process with the aim of answering the following questions: (1) What anatomical/disease related factors favor anterior over posterior surgeries? (2) What are the common anterior procedures and how safe and effective are they? (3) What are the most effective options for multilevel CSM? (4) Is there a role for motion preservation? An additional objective is to discuss technical advances that have improved success rates for anterior procedures. Methods: The PubMed database was searched. Keywords were CSM and anterior surgery. Three hundred eighty two articles were found one hundred three were reviewed. Articles describing anterior cervical techniques were selected along with studies describing the various anterior techniques or comparisons of anterior to posterior techniques. Results: Anterior decompression and fusion procedures are more effective than posterior procedures for patients with primarily ventrally located compression especially in the presence of cervical kyphosis. ACDF, ACCF, and hybrid combinations are safe and effective treatment options for multilevel CSM. Anterior procedures may be more cost effective and result in significantly improved postoperative quality of life and health-related quality of life measures compared to posterior procedures. Conclusion: Anterior cervical decompression techniques are safe and effective in the treatment of CSM. Anterior surgeries may be preferable to posterior approaches, when considering health-related quality of life measures and cost effectiveness.

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Anterior cervical surgery for the treatment of cervical degenerative myelopathy

Cited by 48 publications

References 7 publications

Surgical management of cervical spondylotic myelopathy

Surgical management of cervical spondylotic myelopathy

Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study

Anterior Surgical Treatment of Cervical Spondylotic Myelopathy

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