The Spine Journal
Volume 6, Issue 6, Supplement , Pages S242-S251 , November 2006

Surgical management of cervical myelopathy: indications and techniques for multilevel cervical discectomy

  • Virany H. Hillard, MD
  • ,
  • Ronald I. Apfelbaum, MD

      Affiliations

    • Corresponding Author InformationCorresponding 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.

References 

  1. Edwards CC, Riew KD, Anderson PA, Hilibrand AS, Vaccaro AF. Cervical myelopathy: current diagnostic and treatment strategies. Spine J. 2003;3:68–81
  2. Small JM, Dillin WH, Watkins RG. Clinical syndromes in cervical myelopathy. In:  Herkowitz HN,  Garfin SR,  Balderson RA, et al. editor. The spine. Philadelphia: W.B. Saunders; 1999;p. 465–474
  3. Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. 2001;9:376–388
  4. Epstein JA, Epstein NE. The surgical management of cervical spinal stenosis, spondylosis, and myeloradiculopathy by means of the posterior approach. In:  Sherk HH,  Dunn EJ,  Eismont FJ, et al. editor. The cervical spine, 2nd ed. Philadelphia: J.B. Lippincott; 1989;p. 625–643
  5. McCormick WE, Steinmetz MP, Benzel EC. Cervical spondylotic myelopathy: make the difficult diagnosis, then refer for surgery. Cleve Clin J Med. 2003;70:899–904
  6. House PA, Apfelbaum RI. Anterior decompression for myelopathy: multilevel discectomy. In:  Herkowitz HN editors. The cervical spine atlas, 2nd ed. Philadelphia: Lippincott Williams & Williams; 2004;p. 167–183
  7. Apfelbaum RI, Kriskovich MD, Haller JR. On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine. 2000;25:2906–2912
  8. Steinmetz MP, Benzel EC, Apfelbaum RI. Subsidence and dynamic cervical spine stabilization. In:  Benzel EC editors. Spine surgery: techniques, complications avoidance, and management, 2nd ed. Philadelphia: Elsevier Churchill Livingstone; 2005;p. 1477–1485
  9. Zdeblick TA, Ducker TB. The use of freeze-dried allograft bone for anterior cervical fusions. Spine. 1991;16:726–729
  10. Bishop RC, Moore KA, Hadley MN. Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis. J Neurosurg. 1996;85:206–210
  11. Tippets RH, Apfelbaum RI. Anterior cervical fusion with the Caspar instrumentation system. Neurosurgery. 1988;22:1008–1013
  12. Cauthen JC, Kinard RE, Vogler JB, Jackson DE, DePaz OB, Hunter OL, et al. Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients. Spine. 1998;23:188–192
  13. Apfelbaum RI, Dailey AT, Barbera J. Clinical experiences with a new load-sharing anterior cervical plate [abstr 64:144–145]. Paper presented at: Cervical Spine Research Society 27th Annual Meeting; December 16–18, 1999; Seattle, WA.
  14. Brodke DS, Gollogly S, Alexander Mohr R, Nguyen BK, Dailey AT, Bachus KN. Dynamic cervical plates: biomechanical evaluation of load sharing and stiffness. Spine. 2001;26:1324–1329
  15. Balabhadra RS, Kim DH, Zhang HY. Anterior cervical fusion using dense cancellous allografts and dynamic plating. Neurosurgery. 2004;54:1405–1411discussion 11–2
  16. Frempong-Boadu A, Houten JK, Osbom B, Opulencia J, Kells L, Guida DD, et al. Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech. 2002;15:362–368
  17. Yue WM, Brodner W, Highland TR. Persistent swallowing and voice problems after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year follow-up study. Eur Spine J. 2005;14:677–682
  18. Flynn TB. Neurologic complications of anterior cervical interbody fusion. Spine. 1982;7:536–539
  19. Netterville JL, Koriwchak MJ, Winkle M, Courey MS, Ossoff RH. Vocal fold paralysis following the anterior approach to the cervical spine. Ann Otol Rhinol Laryngol. 1996;105:85–91
  20. Jung A, Schramm J, Lehnerdt K, Herberhold C. Recurrent laryngeal nerve palsy during anterior cervical spine surgery: a prospective study. J Neurosurg Spine. 2005;2:123–127
  21. Baron EM, Soliman AM, Gaughan JP, Simpson L, Young WF. Dysphagia, hoarseness, and unilateral true vocal fold motion impairment following anterior cervical diskectomy and fusion. Ann Otol Rhinol Laryngol. 2003;112:921–926
  22. Edwards CC, Karpitskaya Y, Cha C, et al. Accurate identification of adverse outcomes after cervical spine surgery. J Bone Joint Surg Am. 2004;86-A:251–256
  23. Bazaz R, Lee MJ, Yoo JU. Incidence of dysphagia after anterior cervical spine surgery: a prospective study. Spine. 2002;27:2453–2458
  24. Smith-Hammond CA, New KC, Pietrobon R, Curtis DJ, Scharver CH, Turner DA. Prospective analysis of incidence and risk factors of dysphagia in spine surgery patients: comparison of anterior cervical, posterior cervical, and lumbar procedures. Spine. 2004;29:1441–1446
  25. Mayr MT, Subach BR, Comey CH, Rodts GE, Haid RW. Cervical spinal stenosis: outcome after anterior corpectomy, allograft reconstruction, and instrumentation. J Neurosurg. 2002;96:10–16
  26. Curylo LJ, Mason HC, Bohlman HH, Yoo JU. Tortuous course of the vertebral artery and anterior cervical decompression: a cadaveric and clinical case study. Spine. 2000;25:2860–2864
  27. Kraus DR, Stauffer ES. Spinal cord injury as a complication of elective anterior cervical fusion. Clin Orthop Relat Res. 1975;112:130–141
  28. Yonenobu K, Hosono N, Iwasaki M, Asano M, Ono K. Neurologic complications of surgery for cervical compression myelopathy. Spine. 1991;16:1277–1282
  29. Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K. Complications of pedicle screw fixation in reconstructive surgery of the cervical spine. Spine. 2000;25:962–969
  30. Blacklock JB. Fracture of a sublaminar stainless steel cable in the upper cervical spine with neurological injury: case report. J Neurosurg. 1994;81:932–933
  31. O'Toole JE, Olson TJ, Kaiser MG. Surgical management of dissociated motor loss following complex cervical spine reconstruction. Spine. 2004;29:E56–E60
  32. Keegan JJ. The cause of dissociated motor loss in the upper extremity with cervical spondylosis. J Neurosurg. 1965;23:528–536
  33. Greiner-Perth R, Elsaghir H, Bohm H, El-Meshtawy M. The incidence of C5–C6 radiculopathy as a complication of extensive cervical decompression: own results and review of literature. Neurosurg Rev. 2005;28:137–142
  34. Bolesta MJ, Rechtine GR, Chrin AM. Three- and four-level anterior cervical discectomy and fusion with plate fixation: a prospective study. Spine. 2000;25:2040–2044discussion 45–6
  35. Bose B. Anterior cervical instrumentation enhances fusion rates in multilevel reconstruction in smokers. J Spinal Disord. 2001;14:3–9
  36. Caspar W, Geisler FH, Pitzen T, Johnson TA. Anterior cervical plate stabilization in one- and two-level degenerative disease: overtreatment or benefit?. J Spinal Disord. 1998;11:1–11
  37. Wang JC, McDonough PW, Endow KK, Delamarter RB. Increased fusion rates with cervical plating for two-level anterior cervical discectomy and fusion. Spine. 2000;25:41–45
  38. Emery SE, Bohlman HH, Bolesta MJ, Jones PK. Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy: two to seventeen-year follow-up. J Bone Joint Surg Am. 1998;80:941–951
  39. Epstein N. Anterior approaches to cervical spondylosis and ossification of the posterior longitudinal ligament: review of operative technique and assessment of 65 multilevel circumferential procedures. Surg Neurol. 2001;55:313–324
  40. Apfelbaum RI, Dailey AT, Soleau S, Barbera J. Clinical experience with a new load-sharing anterior cervical plate. In:  Watanabe K editors. Developments in neuroscience: Proceedings of the 2nd International Mt. BANDAI symposium for neuroscience. Spine Section. Philadelphia: Elsevier; 2002;p. 563–580
  41. Paramore CG, Dickman CA, Sonntag VK. Radiographic and clinical follow-up review of Caspar plates in 49 patients. J Neurosurg. 1996;84:957–961
  42. Pickett GE, Van Soelen J, Duggal N. Controversies in cervical discectomy and fusion: practice patterns among Canadian surgeons. Can J Neurol Sci. 2004;31:478–483

 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.

PII: S1529-9430(06)00299-3

doi: 10.1016/j.spinee.2006.05.005

The Spine Journal
Volume 6, Issue 6, Supplement , Pages S242-S251 , November 2006