Experimental chronic compressive cervical myelopathy: effects of decompression

Hl, Harkey; Al‐Mefty, Ossama; Marawi, Isam; Df, Peeler; De, Haines; Lf, Alexander

doi:10.3171/jns.1995.83.2.0336

Cited by 63 publications

(40 citation statements)

References 33 publications

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“…However, as the degree of compression increases, there is a rapid reduction of spinal cord blood flow leading to ischemia once the autoregulatory limits have been exceeded. Pathological examination revealed irreversible changes, including flattening of the anterior horn, disappearance and necrosis of anterior horn cells in the grey matter, and demyelination and axonal degeneration in the white matter [8,12]. The mean duration of spinal cord compression in these animal studies was 10 months, which is close to the mean duration of symptoms before diagnosis in clinical reports on spinal meningiomas.…”

Section: Discussionsupporting

confidence: 47%

“…Whether acute or chronic, spinal cord compression damages neural tissue both by mechanical and vascular mechanisms. Experimental subacute and chronic compressive myelopathy has shown that the first modification is impairment of somatosensory evoked potentials, which is attributable to a mechanical factor [7,8,12]. However, as the degree of compression increases, there is a rapid reduction of spinal cord blood flow leading to ischemia once the autoregulatory limits have been exceeded.…”

Section: Discussionmentioning

confidence: 99%

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Results of spinal meningioma surgery in patients with severe preoperative neurological deficits

et al. 2004

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Results of spinal meningioma surgery in patients with severe preoperative neurological deficits

et al. 2004

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“…In elderly Japanese CSM patients, the rate of occurrence of dynamic factors, such as instability of the vertebral column [1,[6][7][8]29], was shown to be higher than for static factors, such as developmental canal stenosis [24], by radiological analysis [26]. Furthermore, CSM patients 65 years and older with spondylolisthesis had a high incidence of degenerative spondylolisthesis (DS) at C3-C4 or C4-C5 [14].…”

Section: Introductionmentioning

confidence: 99%

Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients

Shigematsu

2010

Eur Spine J

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The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients ([65 years old) who eventually had surgical treatment for CSM were evaluated. A slippage displacement of more than 2.5 mm at least at one level was classified to have a positive DS on flexion/extension radiographs (DS group). A slippage displacement less than 1.0 mm was considered a negative DS (non-DS group). Seventeen patients who had slippage of 1.0-2.5 mm were excluded from the study. The DS group (n = 15) included cases with DS at preoperation, while the remaining cases (n = 17) belonged to the non-DS group. The flexion/ extension radiographs of the two groups were compared for range of motion and clinical results at 3 years after the operation. Of all elderly patients, 30.6% had DS. There was no significant difference between the two groups based on the clinical results. The range of motion of all cervical spines (DS group and non-DS group) was significantly limited. However, there was no significant difference between the two groups. New postoperative DS appeared in four patients, of which two were from the DS group and two from the non-DS group. These data suggest that degenerative spondylolisthesis does not influence surgical results in elderly cervical spondylotic myelopathy patients.

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“…Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up. ported experimentally [16]. Many important variables, however, play a role in a clinical situation that could be different from the experimental conditions in animals.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

Kadaňka

Bednařík

Voháňka

et al. 2000

European Spine Journal

125

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IntroductionSpondylotic cervical myelopathy (SCM) is the most frequent cause of myelopathy in those over the age of 50 [48]. It is believed to have a generally progressive course over a period of years, with sudden acceleration especially following a slight head and neck injury, leading to significant disability [24,45,49]. The treatment of SCM remains a problem, particularly in the mild and moderate forms without rapid progression. There is no strong evidence to show that decompressive surgery with an anterior or posterior approach can improve the clinical outcome of the victims of this disease. This uncertainty persists despite the fact that decompression is a logical answer to the stenotic process, and that this approach is supAbstract A prospective randomised 2-year study was performed to compare the conservative and operative treatment of mild and moderate forms of spondylotic cervical myelopathy (SCM). Forty-eight patients presenting with the clinical syndrome of SCM, with a modified Japanese Orthopaedic Association (mJOA) score of 12 points or more, were randomised into two groups. Group A, treated conservatively, consisted of 27 patients, mean age 55.6 ± 8.6 years, while group B was treated surgically (21 patients, mean age 52.7 ± 8.1 years). The clinical outcome was measured by the mJOA score, recovery rate (RR), timed 10 m walk, score of daily activities (recorded by video and evaluated by two observers blinded to the therapy), and by the subjective assessment of the patients at 6, 12, and 24 months of the follow-up. There was, on average, no significant deterioration in mJOA score, recovery ratio, or timed 10 m walk within either group during the 2 years of follow-up. In the surgery group there was a slight decline in the scores for daily activities and subjective evaluation. A comparison of the two groups showed no significant differences in changes over time in mJOA score or quantified gait, but there were significant differences in the score of daily activities recorded by video at 24 months, which was a little lower in the surgical group, and also in RR and subjective evaluation, which were both worse in the surgical group at months 12 and 24. However, at month 6, this last parameter was significantly better in the surgical than in conservative group. Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up.

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Experimental chronic compressive cervical myelopathy: effects of decompression

Cited by 63 publications

References 33 publications

Results of spinal meningioma surgery in patients with severe preoperative neurological deficits

Results of spinal meningioma surgery in patients with severe preoperative neurological deficits

Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

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