Central corpectomy for cervical spondylotic myelopathy: a consecutive series with long-term follow-up evaluation

Rl, Saunders; Pm, Bernini; Tg, Shirreffs; Ag, Reeves

doi:10.3171/jns.1991.74.2.0163

Cited by 211 publications

(100 citation statements)

References 43 publications

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“…[8] On the other hand, laminectomy plus DLS has no significant acute risks for ventral bone graft and upper airway complications. [24,65] Furthermore, long-term risks of accelerated degenerative changes above and below the fusion are not factors. [34] The similarity of neurological results (compared with ventral decompressive operations) may be related to the effective ventral decompression associated with DLS (that is, relief of the coronal bowstring effect).…”

Section: Dorsal Approachesmentioning

confidence: 99%

Cervical spondylotic myelopathy: surgical decision making

Naderi¹,

Benzel²,

Baldwin³

1996

FOC

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Cervical spondylotic myelopathy can produce a variety of clinical signs and symptoms secondary to neural compromise and biomechanical involvement of the spine. The surgical treatment of cervical spondylotic myelopathy remains a controversial issue after many years of study, evolution, and refinement. Several ventral, dorsal, or combined approaches have been defined. The complications associated with ventral approaches and the concerns about kyphosis following dorsal approaches led to the development of a variety of laminoplasty procedures. This paper reviews the biomechanical basis of cervical spondylotic myelopathy and its effect on choosing the appropriate surgical approach.

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Section: Dorsal Approachesmentioning

confidence: 99%

Cervical spondylotic myelopathy: surgical decision making

Naderi¹,

Benzel²,

Baldwin³

1996

FOC

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“…Horner's syndrome (ptosis, ipsilateral miosis, anhydrosis) resulting from the anterior surgical approaches to the cervical spine or cervicothoracic junction has been documented [1,9,15,16]. Incidence of Horner's syndrome after anterior cervical spine surgeries has varied between 0.2 [18] and 4% [7,8].…”

Section: Introductionmentioning

confidence: 99%

Surgical anatomy of the cervical sympathetic trunk during anterolateral approach to cervical spine

et al. 2008

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The sympathetic trunk is sometimes damaged during the anterior and anterolateral approach to the cervical spine, resulting in Horner's syndrome. No quantitative regional anatomy in fresh human cadavers describing the course and location of the cervical sympathetic trunk (CST) and its relation to the longus colli muscle (LCM) is available in the literature. The aims of this study are to clearly delineate the surgical anatomy and the anatomical variations of CST with respect to the structures around it and to develop a safer surgical method that will diminish the potential risk of CST injury. In this study, 30 cadavers from the Department of Forensic Medicine were dissected to observe the surgical anatomy of the CST. The cadavers used in this study were fresh cadavers chosen at 12-24 h postmortem. The levels of superior and intermediate ganglions of cervical sympathetic chain were determined. The distance of the sympathetic trunk from the medial border of LCM at C6, the diameter of the CST at C6 and the length and width of the superior and intermediate (middle) cervical ganglion were measured. Cervical sympathetic chain is located posteromedial to carotid sheath and just anterior to the longus muscles. It extends longitudinally from the longus capitis to the longus colli over the muscles and under the prevertebral fascia. The average distance between the CST and medial border of the LCM at C6 is 11.6 ± 1.6 mm. The average diameter of the CST at C6 is 3.3 ± 0.6 mm. Superior ganglion of CSC in all dissections was located at the level of C4 vertebra. The length and width of the superior cervical ganglion were 12.5 ± 1.5 and 5.3 ± 0.6 mm, respectively. The location of the intermediate (middle) ganglion of CST showed some variations. The length and width of the middle cervical ganglion were 10.5 ± 1.3 and 6.3 ± 0.6 mm, respectively. The CST's are at high risk when the LC muscle is cut transversely, or when dissection of the prevertebral fascia is performed. Awareness of the CST's regional anatomy may help the surgeon to identify and preserve it during anterior cervical surgeries.

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“…Indications for surgical treatment were persistent and progressive radicular pain, and impaired neurologic function and spinal cord compression documented by CT and MRI studies. Anterior corpectomy and decompression was similar to the procedure described by Saunders et al [5]. After corpectomy, titanium mesh cage filled with local autogeneous bone was used for structural anterior column support in our series.…”

Section: Methodsmentioning

confidence: 94%

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

Lü

et al. 2007

Eur Spine J

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Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications of anterior corpectomy in aged patients with cervical myelopathy. Twenty patients 70 years of age or older who underwent anterior corpectomy, titanium mesh cage (TMC) reconstruction and anterior plate fixation for the treatment of compressive cervical myelopathy were reviewed. The average age at the time of operation was 75 years. Neurologic deficits before and after surgery were assessed using a scoring system proposed by the Japanese Orthopedic Association (JOA Score). Clinical results and post-operative complications were compared with those of patients 69 years old or younger as a control. Pre-operative Radiologic evaluation of every patient consisted of anterior-posterior, lateral, bilateral oblique, flextion, and extension radiographs, computed tomography and magnetic resonance imaging of the cervical spine. Any factor causing spinal cord compression and the sign of cervical instability were recorded. Surgical-related complications occurred in seven patients in the aged group. The incidence of complications was 35% in the aged patient group and 9.7% in the control group respectively. Although the difference was striking, no statistical significance was found between the two groups. One patient died of respiratory failure resulting from pulmonary infection. The mortality rate was 5%. The pre-operative mean JOA score was 9.3 (from 3 to 14) in the aged patient group. Nineteen patients were followed at least 2 years and the mean JOA score was 13.4 (from 8 to 17). 68.4% of the aged patients achieved a good or excellent result. There was no statistical difference in the recovery rate of JOA score between the aged group (58.1%) and control group (67.0%). In the pre-operative radiographs, the incidence of cervical instability was much higher in the control group (32%) than in the aged group (5%) and multilevel cord compression caused by posterior disc space osteophytes was more common in the aged group. Anterior corpectomy combined with TMC fusion and plate fixation provides favorable neurologic recovery even in the patients over 70 years old. However, the incidence of surgical related complications shows a conspicuous increasing in the aged patients. Overcompensation mechanism for cervical instability is the probable cause of degenerative cervical spondylotic myelopathy in aged patients.

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Central corpectomy for cervical spondylotic myelopathy: a consecutive series with long-term follow-up evaluation

Cited by 211 publications

References 43 publications

Cervical spondylotic myelopathy: surgical decision making

Cervical spondylotic myelopathy: surgical decision making

Surgical anatomy of the cervical sympathetic trunk during anterolateral approach to cervical spine

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

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