The long-term results of localised anterior cervical decompression and fusion in spondylotic myelopathy

Irvine, G. Brent; Strachan, W E

doi:10.1038/sc.1987.7

Cited by 18 publications

(10 citation statements)

References 17 publications

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“…By their nature, these diseases are generally not life threatening and occur in middle-aged patients. 1,4,6,9,31,32 Postoperative life expectancies of several decades emphasize the importance of a sufficiently long follow-up period in the evaluation of cervical discectomy performed together with interbody fusion as a procedure.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up After Interbody Fusion of the Cervical Spine

Goffin

Geusens

Vantomme

et al. 2004

Journal of Spinal Disorders

428

217

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Summary:The aim of this work was to add to the body of data on the frequency and severity of degenerative radiographic findings at adjacent levels after anterior cervical interbody fusion and on their clinical impact and to contribute to the insights about their pathogenesis. One hundred eighty patients who were treated by anterior cervical interbody fusion and who had a follow-up of >60 months were clinically and radiologically examined by independent investigators. For all patients, the long-term Odom score was compared with the score as obtained 6 weeks after surgery. For myelopathic cases, both the late Nurick and the Odom score were compared with the initial postoperative situation. For the adjacent disc levels, a radiologic "degeneration score" was defined and assessed both initially and at longterm follow-up. At late follow-up after anterior cervical interbody fusion, additional radiologic degeneration at the adjacent disc levels was found in 92% of the cases, often reflecting a clinical deterioration. The severity of this additional degeneration correlated with the time interval since surgery. The similarity of progression to degeneration between younger trauma patients and older nontrauma patients suggests that both the biomechanical impact of the interbody fusion and the natural progression of pre-existing degenerative disease act as triggering factors for adjacent level degeneration.

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up After Interbody Fusion of the Cervical Spine

Goffin

Geusens

Vantomme

et al. 2004

Journal of Spinal Disorders

428

217

View full text Add to dashboard Cite

show abstract

“…2 Long-term outcomes of both methods have been reported separately. 3,4 However, very few studies have compared the anterior and posterior methods and discussed their advantages and disadvantages. 5,6 At our institution, the first choice of surgical treatment for CSM was, in principle, SC, to expand the spinal canal from an anterior approach 7 between 1984 and 1989, but this has been changed to expansive open-door LP from a posterior approach since 1989.…”

Section: Introductionmentioning

confidence: 99%

Differences between subtotal corpectomy and laminoplasty for cervical spondylotic myelopathy

Shibuya

Komatsubara

Oka³

et al. 2009

Spinal Cord

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Objective: This study aimed to obtain guidelines for choosing between subtotal corpectomy (SC) and laminoplasty (LP) by analysing the surgical outcomes, radiological changes and problems associated with each surgical modality. Study Design: A retrospective analysis of two interventional case series. Setting: Department of Orthopaedic Surgery, Kagawa University, Japan. Methods: Subjects comprised 34 patients who underwent SC and 49 patients who underwent LP. SC was performed by high-speed drilling to remove vertebral bodies. Autologous strut bone grafting was used. LP was performed as an expansive open-door LP. The level of decompression was from C3 to C7. Clinical evaluations included recovery rate (RR), frequency of C5 root palsy after surgery, re-operation and axial pain. Radiographic assessments included sagittal cervical alignment and bone union. Results: Comparisons between the two groups showed no significant differences in age at surgery, preoperative factors, RR and frequency of C5 palsy. Progression of kyphotic changes, operation time and volumes of blood loss and blood transfusion were significantly greater in the SC (two-or threelevel) group. Six patients in the SC group required additional surgery because of pseudoarthrosis, and four patients underwent re-operation because of adjacent level disc degeneration. In the LP group, the problem of elimination of postoperative axial symptoms remains to be solved. Conclusions: The merit of SC is the low frequency of axial symptoms. One-level SC can be considered to have similar degree of invasiveness as LP. Compared with SC, LP is more suitable for elderly patients with multilevel stenosis.

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“…, 1993; Kohno et al. , 1997), others found no correlation (Irvine and Strachan, 1987). In this study, age was not significant predictor of outcome in surgically treated patients, but significantly better results were observed in older patients treated conservatively.…”

Section: Discussionmentioning

confidence: 94%

Predictive factors for spondylotic cervical myelopathy treated conservatively or surgically

Kadaňka¹,

Mareš²,

Bednařík³

et al. 2004

Euro J of Neurology

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A prospective 3-year randomized study comparing conservative and surgical treatment of spondylotic cervical myelopathy to establish predictive factors for outcome after conservative treatment and surgery. The clinical, electrophysiological and imaging parameters were examined to reveal how they characterized the clinical outcome. The patients with a good outcome in the conservatively treated group were of older age before treatment, had normal central motor conduction time (CMCT), and possessed a larger transverse area of the spinal cord. The patients with a good outcome in the surgically treated group had a more serious clinical picture (expressed in mJOA score and slower walk). Patients should rather be treated conservatively if they have a spinal transverse area larger than 70 mm2, are of older age and have normal CMCT. Surgery is more suitable for patients with clinically worse status and a lesser transverse area of spinal cord.

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The long-term results of localised anterior cervical decompression and fusion in spondylotic myelopathy

Cited by 18 publications

References 17 publications

Long-Term Follow-Up After Interbody Fusion of the Cervical Spine

Long-Term Follow-Up After Interbody Fusion of the Cervical Spine

Differences between subtotal corpectomy and laminoplasty for cervical spondylotic myelopathy

Predictive factors for spondylotic cervical myelopathy treated conservatively or surgically

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