Cervical Spondylotic Myelopathy: When and Why the Cervical Corpectomy?
Adult
Aged
Cervical Vertebrae
/ surgery
Decompression, Surgical
/ methods
Female
Functional Status
Humans
Intervertebral Disc Degeneration
/ complications
Intervertebral Disc Displacement
/ complications
Male
Middle Aged
Ossification of Posterior Longitudinal Ligament
/ complications
Prospective Studies
Severity of Illness Index
Spinal Cord Compression
/ etiology
Spinal Fusion
Spondylosis
/ complications
Treatment Outcome
Young Adult
Cervical corpectomy
Cervical spondylotic myelopathy
Degenerative cervical myelopathy
Surgical outcomes
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
14
02
2020
revised:
16
03
2020
accepted:
17
03
2020
entrez:
17
8
2020
pubmed:
17
8
2020
medline:
17
12
2020
Statut:
ppublish
Résumé
Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The best treatment option has remained controversial. We performed a prospective study to evaluate the clinical, radiographic, and neurophysiologic outcomes for anterior cervical corpectomy in the treatment of CSM. From January 2011 to January 2017, 60 patients with CSM were prospectively enrolled in the present study. The patients were divided according to the modified Japanese Orthopaedic Association scale (mJOA) score into 2 groups: group A, patients with mild to moderate CSM (mJOA score ≥13); and group B, patients with severe myelopathy (mJOA score <13). Data were collected for each participating subject, including demographic information, symptoms, medical history, radiologic and neurophysiologic features, and functional impairment. Of the 60 patients, 35 were men (58.3%) and 25 were women (41.7%). Their average age was 57.48 ± 10.60 years. The mean symptom duration was 25.33 ± 16.00 months; range, 3-57 months). Of the 60 patients, 22 had undergone single-level corpectomy and 36 multilevel corpectomy. A significant improvement in the motor evoked potentials was observed in both groups. Single- and multilevel corpectomy are valid and safe options in the treatment of CSM. In the present prospective study, a statistically significant improvement in the mJOA score and neurophysiologic parameters was observed for both moderate and severe forms of CSM.
Sections du résumé
BACKGROUND
Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The best treatment option has remained controversial. We performed a prospective study to evaluate the clinical, radiographic, and neurophysiologic outcomes for anterior cervical corpectomy in the treatment of CSM.
METHODS
From January 2011 to January 2017, 60 patients with CSM were prospectively enrolled in the present study. The patients were divided according to the modified Japanese Orthopaedic Association scale (mJOA) score into 2 groups: group A, patients with mild to moderate CSM (mJOA score ≥13); and group B, patients with severe myelopathy (mJOA score <13). Data were collected for each participating subject, including demographic information, symptoms, medical history, radiologic and neurophysiologic features, and functional impairment.
RESULTS
Of the 60 patients, 35 were men (58.3%) and 25 were women (41.7%). Their average age was 57.48 ± 10.60 years. The mean symptom duration was 25.33 ± 16.00 months; range, 3-57 months). Of the 60 patients, 22 had undergone single-level corpectomy and 36 multilevel corpectomy. A significant improvement in the motor evoked potentials was observed in both groups.
CONCLUSIONS
Single- and multilevel corpectomy are valid and safe options in the treatment of CSM. In the present prospective study, a statistically significant improvement in the mJOA score and neurophysiologic parameters was observed for both moderate and severe forms of CSM.
Identifiants
pubmed: 32797986
pii: S1878-8750(20)30571-4
doi: 10.1016/j.wneu.2020.03.100
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
548-555Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.