Surgical Approach to Radicular Pain of the Degenerative Cervical Spine

♦ Degenerative cervical spine disorders may manifest clinically with axial neck pain, radiculopathy, myelopathy, or a combination of these clinical symptoms♦ The findings on radiographs and MRI are pertinent if they correlate with the clinical symptoms♦ The initial treatment for patients with degenerative cervical spine disorders is conservative, including non-narcotic analgesics, anti-inflammatory medications, exercise program, physiotherapy, and occasional injections♦ Surgical indications include significant radicular pain despite conservative treatment, profound neurologic deficits, and presence of significant myelopathy♦ Surgical treatment for cervical radiculopathy includes lamino-foraminotomy, anterior cervical discectomy and fusion (ACDF), and artificial disk replacement, and surgical treatment for myelopathy includes anterior discectomy and/or corpectomy with fusion, posterior laminoplasty, and posterior laminectomy and fusion. The surgeon should be familiar with the specific indications as well as advantages and disadvantages of each procedure.

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Posterior microendoscopic surgical approach for the degenerative cervical spine

Neurological Research ◽

10.1179/016164103101201058 ◽

2003 ◽

Vol 25 (1) ◽

pp. 17-21 ◽

Cited By ~ 10

Author(s):

Takamichi Yuguchi ◽

Masami Nishio ◽

Chihiro Akiyama ◽

Mamoru Ito ◽

Toshiki Yoshimine

Keyword(s):

Cervical Spine ◽

Surgical Approach ◽

Degenerative Cervical Spine

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Surgical treatment of degenerative cervical spine diseases: Analyses of 90 patients clinical study

Acta chirurgica iugoslavica ◽

10.2298/aci1203061m ◽

2012 ◽

Vol 59 (3) ◽

pp. 61-68

Author(s):

M. Markovic ◽

N. Zivkovic ◽

D. Stojanovic ◽

M. Samardzic

Keyword(s):

Cervical Spine ◽

Surgical Approach ◽

Iliac Crest ◽

Cervical Disc ◽

Cervical Spine Surgery ◽

Clinical Series ◽

Cervical Approach ◽

Anterior Cervical Approach ◽

Cervical Plating ◽

Degenerative Cervical Spine

The effect of degenerative cervical spine surgery depends on good understanding of the pathogenesis and clinical course of disease with a detailed neurological and neuroradiological examination. Surgical approach should be considered separately for each pathological substrate in order to avoid additional morbidity. The aim of our study is to present the results of treatment through analysis of large clinical series focusing on anterior surgical approach with iliac crest graft fusion without cervical plating. The retrospective analysis of 90 patients operated on Neurosurgery of CHC Zemun, from 2008 to 2011, was done. In 81 patients cervical disc herniation was found in one or two levels, and 9 patients had spinal canal stenosis with polydiscopathy. Preoperatively 50 patients had cervical myelopathy, and 40 patients had radiculopathy as dominating clinical sign. Anterior cervical approach was performed in 79 patients, and 11 patients were operated by posterior approach. The treatment outcome was as follows: good outcome 16 (16.8%) patients, improved condition 65 (72.2%), without improvement 6 (6.7%), bad outcome 3 (4.3%). The anterior cervical approach with iliac crest autologous graft fusion, and without additional cervical plating, is reliable treatment option with results comparable to reported clinical series with sintetic graft placement and anterior cervical plate stabilisation.

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Neurophysiological Assessment of Degenerative Cervical Spine Disorders

10.28962/01.3.026 ◽

2017 ◽

Author(s):

Fahed Zairi

Keyword(s):

Cervical Spine ◽

Neurophysiological Assessment ◽

Degenerative Cervical Spine ◽

Spine Disorders

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A rare case of Paget’s disease affecting the cervical spine

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0187 ◽

2019 ◽

Vol 101 (2) ◽

pp. e38-e42

Author(s):

J Holton ◽

M Jones ◽

Z Klezl ◽

M Czyz ◽

M Grainger ◽

...

Keyword(s):

Cervical Spine ◽

Independent Living ◽

Paget’S Disease ◽

Posterior Part ◽

Cord Compression ◽

Bone Cell ◽

Paget's Disease ◽

History Of ◽

Posterior Instrumented Fusion ◽

Degenerative Cervical Spine

We present the case of a 75-year-old man with a rapidly progressive cervical myelopathy on a background of a 3-year history of neck pain and a severely degenerative cervical spine. The patient developed progressive myelopathy over a six-month period and suffered from worsening kyphosis. Suspicion of an underlying oncological process prompted transfer to our tertiary referral unit. Biopsy was consistent for Paget’s disease, an extremely rare diagnosis of the cervical spine. Magnetic resonance imaging revealed cord compression between C4 and C6 with associated cord signal change indicative of myelopathy. A three-level corpectomy and posterior instrumented fusion was performed. There was significant blood loss (3.5l) intraoperatively, consistent with a diagnosis of Paget’s disease of the bone. Cell salvage was used, as was neuromonitoring for both the anterior and posterior part of the procedure. Postoperatively, neurological function improved slightly and the patient required community neurorehabilitation to allow independent living.

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