Surgical management of cervical myelopathy: indications and techniques for multilevel cervical discectomy
Abstract
Background context
Surgery is usually required for treatment of cervical myelopathy to decompress the neural elements, restore lordosis, and stabilize the spine. By addressing these problems, the neurological deterioration may be halted.
Purpose
Multilevel cervical discectomy and fusion offers several advantages over other approaches. The authors describe the technique, discuss the indications, and present the potential complications associated with it.
Methods
Decompression is achieved via discectomy and subsequent removal of the osteophytes using a curetting technique. Preparation of end plates in a parallel fashion allows for gapless grafting of allograft bone for enhancement of fusion. A dynamic plate and screw system strengthens the construct.
Results
A high rate of fusion can be obtained using the technique of multilevel cervical discectomy and fusion with acceptable levels of complications. It is especially useful in cases of spondylosis that have a kyphotic deformity because, in addition to anterior decompression, it allows reconstruction of the spine to help restore a lordotic curvature.
Conclusions
Multilevel cervical discectomy and fusion has proven to be very effective in decompressing and stabilizing the spine for treatment of cervical myelopathy.
Corresponding author. Department of Neurosurgery, University of Utah School of Medicine, 30 North 1900 East, Suite 3B409, Salt Lake City, UT 84132. Tel.: (801) 581-6908; fax: 801-581-4138.
FDA device/drug status: approved for this indication (anterior cervical plating [ABC Plate]).
Author RIA acknowledges a financial relationship (consultant for Aesculap Instrument Co., Center Valley, PA) that may indirectly relate to the subject of this research.
ABSTRACT