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Effects of surgery on cervical spondylotic myelopathy

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Summary

The results of surgery for treatment of cervical spondylotic myelopathy (CSM) were assessed 3 months (early results) and 2–8 years (late results) postoperatively in 99 patients.

Extensive laminectomy as well as anterior decompression and fusion, or the two procedures at staged intervals, were used.

Immediate postoperative deterioration was never seen after laminectomy performed under local anaesthesis (84 patients), while transient deterioration occurred after anterior surgery in 2 of 28 patients.

Cervical spondylotic radiculopathy (CSR) was found in 73% of the patients. Operative treatment for CSM also improved root symptoms, anterior surgery to a larger extent than posterior decompression. Only 10% of the patients treated with extensive laminectomy needed a second anterior operation for radiculopathy.

The progression of myelopathy was arrested in 95% of the patients after surgery. Improvement was obtained in 80% both in the early and late follow-up review when compared to the preoperative functional status. The evaluation disclosed a tendency of rapid improvement during the first 3 months, subsequently followed by slow improvement in 50% and slight deterioration in 15% of the patients.

The degree of improvement was in many patients not sufficient to raise the functional capability to a higher level in the employed grading system. In our opinion it is therefore important to operate patients with CSM as early as possible before neurological deficits are too pronounced.

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References

  1. Aboulker J, Metzger J, David M,et al. (1965) Les myelopathies cervicales d'origine rachidiene. Neurochirurgie 11: 89–198

    Google Scholar 

  2. Clarke E, Robinson PK (1956) Cervical myelopathy: A complication of cervical spondylosis. Brain 79: 483–510

    PubMed  Google Scholar 

  3. Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15: 602–617

    PubMed  Google Scholar 

  4. Dereymaeker A, Ghosez J-P, Henkes R (1963) Le traitement chirurgical de la discopathie cervicale. Neurochirurgie 9: 13–20

    PubMed  Google Scholar 

  5. Epstein JA, Carras R, Lavine LS,et al. (1969) The importance of removing osteophytes as part of the surgical treatment of myeloradiculopathy in cervical spondylosis. J Neurosurg 30: 219–226

    PubMed  Google Scholar 

  6. Eriksen EF, Buhl M, Fode K,et al. (1984) Treatment of cervical disc disease using Cloward's technique. The prognostic value of clinical preoperative data in 1,106 patients (with 2 figures). Acta Neurochir (Wien) 70: 181–197

    Google Scholar 

  7. Espersen JO, Buhl M, Eriksen EF,et al. (1984) Treatment of cervical disc disease using Cloward's technique. I. General results, effect of different operative methods and complications in 1,106 patients (with 7 figures). Acta Neurochir (Wien) 70: 97–114

    Google Scholar 

  8. Fager CA (1973) Results of adequate posterior decompression in relief of spondylotic cervical myelopathy. J Neurosurg 38: 684–692

    PubMed  Google Scholar 

  9. Gorter K (1976) Influence of laminectomy on the course of cervical myelopathy. Acta Neurochir (Wien) 33: 265–281

    Google Scholar 

  10. Gregorius FK, Estrin T, Crandall PH (1976) Cervical spondylotic radiculopathy and myelopathy. A long time follow-up study. Arch Neurol 33: 618–625

    PubMed  Google Scholar 

  11. Guidetti B, Fortuna A (1969) Long-term results of surgical treatment of myelopathy due to cervical spondylosis. J Neurosurg 30: 714–721

    PubMed  Google Scholar 

  12. Husag L, Probst Ch (1984) Microsurgical anterior approach to cervical discs. Review of 60 consecutive cases of discectomy without fusion (with 5 figures). Acta Neurochir (Wien) 73: 229–242

    Google Scholar 

  13. Jeffreys RV (1979) The surgical treatment of cervical spondylotic myelopathy. Acta Neurochir (Wien) 47: 293–305

    Google Scholar 

  14. Lunsford LD, Bissonette DJ, Jannetta PJ,et al. (1980) Anterior surgery for cervical disc disease, part I: Treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53: 1–11

    PubMed  Google Scholar 

  15. Lunsford LD, Bissonette DJ, Zorub DS (1980) Anterior surgery for cervical disc disease. Part 2: Treatment of cervical spondylotic myelopathy in 32 cases. J Neurosurg 53: 12–19

    PubMed  Google Scholar 

  16. Mann KS, Khosla VK, Gulati DR (1984) Cervical spondylotic myelopathy treated by single-stage multilevel anterior decompression. A prospective study. J Neurosurg 60: 81–87

    PubMed  Google Scholar 

  17. Mosdal C (1984) Cervical osteochondrosis and disc herniation. Eighteen years' use of interbody fusion by Cloward's technique in 755 cases (with 4 figures). Acta Neurochir (Wien) 70: 207–225

    Google Scholar 

  18. Mosdal C, Overgaard J (1984) Lateral cervical facetectomy. The surgical pathology of radicular brachialgia (with 1 figure). Acta Neurochir (Wien) 70: 199–205

    Google Scholar 

  19. Moussa A, Nitta M, Symon L (1983) The results of anterior cervical fusion in cervical spondylosis. Review of 125 cases (with 3 figures). Acta Neurochir (Wien) 68: 277–288

    Google Scholar 

  20. Nurick S (1972) The pathogenesis of spinal cord disorder associated with cervical spondylosis. Brain 95: 87–100

    PubMed  Google Scholar 

  21. Nurick S (1972) The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis. Brain 95: 101–108

    PubMed  Google Scholar 

  22. Ogino H, Tada K, Okada K,et al. (1983) Canal diameter, anteroposterior compression ratio, and spondylotic myelopathy of the cervical spine. Spine 8: 1–15

    PubMed  Google Scholar 

  23. Phillips DG (1973) Surgical treatment of myelopathy with cervical spondylosis. J Neurol Neurosurg Psychiatry 36: 879–884

    PubMed  Google Scholar 

  24. Robinson RA, Smith GW (1955) Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Hosp 96: 223–224

    Google Scholar 

  25. Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg (Am) 40: 607–624

    Google Scholar 

  26. Vaquero J, Cabezudo JM, Leunda G,et al. (1982) Subjective postoperative results in cervical spondylotic myelopathy. Acta Neurochir (Wien) 62: 95–100

    Google Scholar 

  27. Wohlert L, Buhl M, Eriksen F,et al. (1984) Treatment of cervical disc disease using Cloward's technique. III. Evaluation of cervical spondylotic myelopathy in 138 cases (with 4 figures). Acta Neurochir (Wien) 71: 121–131

    Article  Google Scholar 

  28. Zhang Z-H, Yin H, Yang K,et al. (1983) Anterior intervertebral disc excision and bone grafting in cervical spondylotic myelopathy. Spine 8: 16–19

    PubMed  Google Scholar 

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  1. J. Wiberg

    Present address: Department of Neurosurgery, Rikshospitalet, Oslo, Norway

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    1. J. Wiberg
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    Wiberg, J. Effects of surgery on cervical spondylotic myelopathy. Acta neurochir 81, 113–117 (1986). https://doi.org/10.1007/BF01401231

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