CHOICE OF SURGICAL TREATMENT FOR MULTISEGMENTAL CERVICAL SPONDYLOTIC MYELOPATHY
Journal Title: Journal of Turkish Spinal Surgery - Year 2003, Vol 14, Issue 1
Abstract
Recent advances in surgical techniques have expanded the field of surgical treatment for cervical spondylotic myelopathy. For single-level spondylotic myelopathy, anterior surgery has been widely accepted. However, there is little agreement as to the best approach for multisegmental spondylotic myelopathy, especially when the condition is associated with a narrojw spinal canal. Some authors recommend anterior or posterior decompression exclusively for the surgical treatment of this condition. Others based their decision on various criteria including multiplicity of involvement and the anteroposterior spinal canal diameter. The validity of the opinions, however, has not been substantiated by statistical evidence. We have conducted several comparative studies of results of surgical treatment for cervical spondylotic myelopathy. First, three surgical procedures for multisegmental cervical spondylotic myelopathy; laminectomy, (12-157 month) of 95 patients. Twenty-four multisegmental cervical spondylotic myelopathy; laminectomy, underbody fusion by the Cloward and/or Smith Robinson techniques, and 21 by subtotal spondylectomy and fusion. Results of subtotal spondylectomy were significantly (P less than 0.01) better when compared with those of the other two procedures. Reasons for the inferiority of laminectomy were malalignment and instability of the cervical spine and it was concluded that maintenance of cervical lordosis and stability was the key to stable surgical results after posterior decompression .
Authors and Affiliations
Kazuo Yonenobu, M. D. , D. M. Sc.
Keywords
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