Managing spondylotic cervical myeloradiculopathy using oblique cervical corpectomy

Abstract

Study design: A Prospective clinical case series study. Objective: To evaluate the clinical and radiological outcomes of oblique cervical corpectomy in the management of selected cases of Spondylotic Cervical Myeloradiculopathy. Methods: 18 patients with cervical spondylotic myeloradiculopathy were enrolled in this study. Neurological function was graded by modified Japanese Orthopedic Association scale, and the recovery rate was calculated. Both local symptoms and radicular pain were evaluated using Visual Analog Scale. The minimum follow-up period was 24months. Results: 12 males and 6 females with a mean age of 52years underwent oblique cervical corpectomy with mean operative duration 172minutes. Mean Blood loss was 320ml. Oblique corpectomy was done at a single level in 10 patients, two levels in 6 patients and three levels in 2 patients. There was a statistically significant improvement in both the mJOA scale and VAS for radicular symptoms. Postoperatively spine curvature in most of the cases remained unchanged. The development of straightening or kyphosis of the spine was not correlated with neurological weakness or worsening of clinical improvement. One case had intraoperative dural tear, three cases had postoperative Horner's syndrome that is temporary in two cases and persists in one. Conclusion: Oblique corpectomy is a sound alternative to conventional central corpectomy and fusion in selected cases. By avoiding the use of implants and fusion, the procedure is cost effective with no fusion-related complications but is technically demanding.

Cervical Oblique Corpectomy: Revitalizing the Underused Surgical Approach With Step-By-Step Simulation in Cadavers

“…Low cost alone does not justify the choice of a surgical method 79 . Nevertheless, OC is a beneficial procedure in the surgical treatment of CSM, as in the treatment of some other cervical spinal lesions, including tumors and abscesses 1,80–83 . In a large series with the OC approach, an 87.6% recovery rate has been reported in Modified Japanese Orthopaedic Association scale (mJOA) scores of patients with CSM 20 .…”

“…79 Nevertheless, OC is a beneficial procedure in the surgical treatment of CSM, as in the treatment of some other cervical spinal lesions, including tumors and abscesses. 1,[80][81][82][83] In a large series with the OC approach, an 87.6% recovery rate has been reported in Modified Japanese Orthopaedic Association scale (mJOA) scores of patients with CSM. 20 In a series of 499 patients, 0% cerebrospinal fluid leakage, 0% infections 0% C5 deficit and/or dysphagia/ dysphonia, and 3% transient, 1% permanent impairment Horner syndrome have been reported.…”