Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical

Meluzzi, Alexandre; Taricco, Mario Augusto; Brock, Roger Schimidth; Dias, Mário Rubem Pena; Nakaguawa, Gilberto; Guirado, Vinícius Monteiro de Paula; Teixeira, Manoel Jacobsen

doi:10.1590/s1808-18512012000100010

Cited by 5 publications

(16 citation statements)

References 22 publications

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“…Meluzzi et al observed better improvement in the JOA score after surgery in the group with spinal cord compression at one level compared to the multiple-level group. 19 In the present study, the group with myelopathy at one level had a significantly higher mean postoperative JOA score (mean JOA=14.3) than the multiple-level group (mean JOA=10.6) (p=0.017). Functional and neurological recovery tended to be more favorable and have a better prognosis in the cases with single-level myelopathy.…”

Section: Discussionmentioning

confidence: 39%

“…The condition of patients above 70 years of age had tended to worsen at the 24-month evaluation. 19 Myelopathy occurs due to three physiopathological factors: static, dynamic, and ischemic mechanics. Accentuated hypertrophy of the yellow ligament, instability, cervical vertebral subluxation, and low medullary vascularization (ischemia) are factors frequently encountered in the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…Even though other studies with monitoring periods of 18 and 24 months reported similar results following surgery, some late complications, such as worsening neurological conditions and adjacent-level degeneration, were not able to be identified during this period. 16,19 The surgical approach to be used remains dependent on the experience and preference of the surgeon. Multicenter, prospective studies focused on the access route could assist in decision-making around the most effective approach.…”

Section: Discussionmentioning

confidence: 99%

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Severe Cervical Myelopathy: Approaches and Postoperative Evaluation

Cerqueira

Kulcheski²,

Sebben³

et al. 2021

Coluna/Columna

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Objectives: To evaluate and compare the clinical evolution of surgical approaches used in patients with severe cervical myelopathy. Methods: Retrospective observational study in which 19 patients with myelopathy who underwent surgery were evaluated. Neurological assessments using the Frankel scale were conducted both preoperatively and one year following surgery, and the modified Japanese Orthopedic Association (JOA), Nurick, and Visual Analog Scale for pain (VAS) questionnaires were applied 1 year after the surgical procedure. Results: 89% of the participants were male and the average age was 63.9 years. No patient had postoperative neurological worsening, 12 patients (63.16%) had mild pain, and seven (36.84%) had moderate pain. The group with degenerative disease showed neurological improvement after surgery and the exclusively anterior approach was used in 84% of the cases, the exclusively posterior approach in 10% of the cases, and the dual approach in 6% of the cases. Conclusion: Surgical treatment has good results for inhibiting the unfavorable natural evolution of myelopathy within 1 year following surgery and promotes neurological improvement in degenerative cases, making it possible to use the anterior access route in most cases. Level of evidence III; Retrospective Study.

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Section: Discussionmentioning

confidence: 39%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Severe Cervical Myelopathy: Approaches and Postoperative Evaluation

Cerqueira

Kulcheski²,

Sebben³

et al. 2021

Coluna/Columna

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“…Some studies analyzed and demonstrated the postoperative evolution taking into account the patient's age, smoking history, compromised levels, and cervical spine instability. 9…”

Section: Discussionmentioning

confidence: 99%

Analysis of Myelomalacia and Posterior Longitudinal Ligament Ossification as Prognostic Factors in Patients with Cervical Spondylotic Myelopathy Submitted to Laminoplasty

Antikievicz

Rossi

Maldaun

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Background Cervical spondylotic myelopathy is a degenerative disease of the intervertebral disc and the vertebral body of the spine that causes cervical spinal cord injury due to central vertebral canal stenosis. Its prevalence is higher in the elderly. Treatment is usually surgical when the spinal cord is affected either clinically with pyramidal release or radiologically with the altered spinal cord. Objective The goal of the present study is to analyze the myelomalacia and the ossification of the posterior longitudinal ligament as prognostic factors in the postoperative evolution of patients with cervical canal compression who underwent laminoplasty with the open- or French-door techniques. Methods We performed a retrospective analysis of 18 surgical cases of spondylotic cervical myelopathy of the same senior neurosurgeon, using the chi-squared test to analyze prognostic factors for patients' postoperative evolution in the Nurick scale, after open-door or French-door laminoplasty. Findings The comparison between the pre and postoperative showed an improvement of 71.43% in cases that did not have ligament ossification compared with 45.45% of cases that presented posterior longitudinal ligament ossification. Also, there was a better prognosis in patients without myelomalacia, as 71.43% of them improved their condition against only 45.45% of improvement in those with myelomalacia. Conclusion There is a need for further studies with larger samples to expressively prove that the presence of longitudinal ligament ossification and the previous presence of myelomalacia are factors that can lead to worse prognosis in the postoperative evolution of patients with cervical spondylotic myelopathy submitted to laminoplasty.

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“…Success in the surgical treatment of the patient with spondylotic cervical myelopathy is highly dependent on the previous factors presented by the patient. Some studies analyzed and demonstrated the postoperative evolution taking into account the patient's age, smoking history, compromised levels, and cervical spine instability 9 .…”

Section: Originalmentioning

confidence: 99%

Analysis of myelomalacia and posterior longitudinal Ligament ossification as prognostic factors in patients with cervical spondylotic myelopathy submitted to laminoplasty

Antikievicz¹,

Rossi²,

Maldaun³

et al. 2021

jbnc

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Background: Cervical spondylotic myelopathy is a degenerative disease of the intervertebral disc and vertebral body of the spine that causes cervical spinal cord injury due to central vertebral canal stenosis. Its prevalence is higher in the elderly. Treatment is usually surgical when the spinal cord is affected either clinically with pyramidal release or radiologically with the altered spinal cord. Objective: The rationale of this study is to analyze the myelomalacia and the ossification of posterior longitudinal ligament as prognostic factors in the postoperative evolution of patients with cervical canal compression who underwent laminoplasty by open-door or french-door techniques. Methods: We performed a retrospective analysis of 18 surgical cases of spondylotic cervical myelopathy of the same senior neurosurgeon, using the chi-square test to analyze prognostic factors for patients’ postoperative evolution in the Nurick scale, after open-door or french-door laminoplasty. Results: The comparison between pre and postoperative showed an improvement of 71.43% of cases that did not have ligament ossification compared to 45.45% of cases that presented posterior longitudinal ligament ossification. Also, there was a better prognosis in patients without myelomalacia, as 71.43% of them improved their condition against only 45.45% improvement in those with myelomalacia. Conclusion: There is a need for further studies with larger samples to expressively prove that the presence of longitudinal ligament ossification and the previous presence of myelomalacia are factors of worse prognosis in the postoperative evolution of patients with cervical spondylotic myelopathy submitted to laminoplasty.

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Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical

Cited by 5 publications

References 22 publications

Severe Cervical Myelopathy: Approaches and Postoperative Evaluation

Severe Cervical Myelopathy: Approaches and Postoperative Evaluation

Analysis of Myelomalacia and Posterior Longitudinal Ligament Ossification as Prognostic Factors in Patients with Cervical Spondylotic Myelopathy Submitted to Laminoplasty

Analysis of myelomalacia and posterior longitudinal Ligament ossification as prognostic factors in patients with cervical spondylotic myelopathy submitted to laminoplasty

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