Clinical adjacent-segment pathology after central corpectomy for cervical spondylotic myelopathy: incidence and risk factors

Vedantam, Aditya; Rajshekhar, Vedantam

doi:10.3171/2016.2.focus1626

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…Sarkar, et al [25] reported the most frequent complication following a central corpectomy using autologous iliac crest or fibular strut grafting was a dural tear (4.3%) followed by surgical-site infection (3.4%), C-5 palsy, (1.3%), dysphagia (0.8%), and recurrent laryngeal nerve injury (0.4%). Vedantam, et al [26] reported that the prevalence of Clinical adjacent-segment pathology (CASP) following central corpectomy for CSM was 3.9%. Tan, et al [24] noted that there can be a high instrumentation failure rate of up to 50% to 71.4% when multiple level corpectomies (> 2 levels) are performed [24,27,28].…”

Section: Hybrid Decompressionmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: An Updated Review

P¹,

Bhaveshkumar²,

Nauman³

et al. 2021

Neurosurg Cases Rev

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Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction. The degenerative disease can cause serious neurological symptoms that can significantly affect the quality of life. The heterogenous presentation of CSM and a lack of a single comprehensive outcome instrument can make the management of suspected CSM very difficult. Despite the advances in surgical techniques to treat CSM, the indications to do surgery remain controversial, particularly in older individuals who commonly present with the disease. There is also debate on the optimal surgical approach to treat CSM, and most neurosurgeons remain unfamiliar with the evaluation tools that drive economic health care as a result of the surgical procedures. Here, the scientific literature was carried out using PubMed with the following keywords: cervical spondylotic myelopathy, anterior, posterior, anterior-posterior, elderly, cost-utility analyses. The bibliographies of these papers were also reviewed to yield additional papers of high significance. The goal of this review is to provide insight in to the surgical outcomes, preoperative management decisions, elderly population, and the cost-effectiveness of the types of surgery in relation to cost per quality-adjusted life year (QALY) gained.

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Section: Hybrid Decompressionmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: An Updated Review

P¹,

Bhaveshkumar²,

Nauman³

et al. 2021

Neurosurg Cases Rev

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“…RASP refers to radiographic degeneration at adjacent segment without symptoms; CASP, in contrast, refers to not only degenerative changes at adjacent segment but also clinically related symptoms, such as radiculopathy, myelopathy, or features suggestive of instability. [9]…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with clinical adjacent segment pathology following multi-level cervical fusion surgery

et al. 2018

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Few clinical studies investigate risk factors associated with clinical adjacent segment pathology (CASP) following multi-level cervical fusion surgery. The aim is to record the incidence of postoperative CASP in patients after at least 2 years′ follow-up and to identify possible risk factors that may be associated with the CASP after multi-level cervical surgery.We retrospectively reviewed patients who underwent multi-level cervical surgery in our hospital from January 2004 to February 2016. All patients underwent more than 2 years′ follow-up. The diagnosis of CASP is according to clinical symptoms as well as image findings. Potential risk factors were collected from demographic data and radiographic images.A total of 301 patients after multi-level cervical surgery were analyzed. During follow-up, 28 patients (9.3%) were diagnosed as having CASP. Among these patients, 7 showed symptoms of CASP within 3 years after surgery, 6 showed symptoms between 3 and 5 years, 14 showed symptoms between 5 and 10 years, and the last one showed symptoms more than 10 years later. In the multivariate analysis, degeneration of adjacent segment (OR, 1.592; 95% CI, 1.113–2.277), decreased Cobb angle in fused vertebrae (OR, 2.113; 95% CI, 1.338–3.334) and decreased Cobb angle in cervical spine (OR, 1.896; 95% CI, 1.246–2.886) were correlated with the incidence of CASP during follow-up.The incidence of CASP following multi-level cervical surgery was 9.3% with a mean of about 70 months′ follow-up. Patients with preoperative degeneration of adjacent segment and postoperative imbalance of sagittal alignment have a higher risk of developing CASP after multi-level cervical surgery.

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