Relationship between developmental canal stenosis and surgical results of anterior decompression and fusion in patients with cervical spondylotic myelopathy

Object The purpose of this study was to investigate the prevalence of developmental canal stenosis in patients with cervical spondylotic myelopathy (CSM), and the correlation between surgical results and degree of developmental canal stenosis. Methods A total of 112 patients who eventually had surgical treatment for CSM were evaluated. Male patients whose sagittal spinal diameter was < 14 mm and females whose sagittal diameter was < 13 mm even at one level were classified as having developmental canal stenosis. Two groups of patients were used in this study; the “positive” group (57 cases) included patients with developmental canal stenosis preoperatively, whereas the “negative” group (55 cases) excluded such patients. Lateral functional radiographs obtained in patients in the 2 groups were compared for range of motion and clinical results. Results Developmental canal stenosis was found in 50.9% of all cases. Based on clinical results, there was no significant difference between the 2 groups. Conclusions Patients with CSM showed a high incidence of preoperative developmental canal stenosis. However, there were no significant differences in clinical results between patients with and without this disorder. These results indicate that developmental canal stenosis is not a factor that influences surgical results.

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Anterior decompression and fusion with intervertebral fusion cage(Solis) in treatment of cervical spondylotic myelopathy: an analysis of preliminary effectiveness

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2010.01143 ◽

2010 ◽

Vol 30 (10) ◽

pp. 1143-1145

Author(s):

Peng YUAN ◽

Hui-lin YANG ◽

Li CHENG

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Anterior Decompression ◽

Intervertebral Fusion ◽

Fusion Cage ◽

Anterior Decompression And Fusion

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The application of a new type of titanium mesh cage in hybrid anterior decompression and fusion technique for the treatment of continuously three-level cervical spondylotic myelopathy

European Spine Journal ◽

10.1007/s00586-016-4888-3 ◽

2016 ◽

Vol 26 (1) ◽

pp. 122-130 ◽

Cited By ~ 1

Author(s):

Xiaowei Liu ◽

Yu Chen ◽

Haisong Yang ◽

Tiefeng Li ◽

Haidong Xu ◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Titanium Mesh ◽

Anterior Decompression ◽

Titanium Mesh Cage ◽

Fusion Technique ◽

Mesh Cage ◽

New Type ◽

Anterior Decompression And Fusion

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Surgical treatment of cervical spondylotic myelopathy with anterior compression: a review of 67 cases

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/9/8/152 ◽

2008 ◽

Vol 9 (2) ◽

pp. 152-157 ◽

Cited By ~ 46

Author(s):

Beril Gok ◽

Daniel M. Sciubba ◽

Gregory S. McLoughlin ◽

Matthew McGirt ◽

Selim Ayhan ◽

...

Keyword(s):

Complication Rate ◽

Cervical Spondylotic Myelopathy ◽

Posterior Fixation ◽

Adjacent Segment ◽

Cervical Lordosis ◽

Anterior Decompression ◽

Anterior Surgery ◽

Fusion Procedure ◽

Increased Risk ◽

Anterior Decompression And Fusion

Object In patients with cervical spondylotic myelopathy (CSM), ventral disease and loss of cervical lordosis are considered to be relative indications for anterior surgery. However, anterior decompression and fusion operations may be associated with an increased risk of swallowing difficulty and an increased risk of nonunion when extensive decompression is performed. The authors reviewed cases involving patients with CSM treated via an anterior approach, paying special attention to neurological outcome, fusion rates, and complications. Methods Retrospectively, 67 cases involving consecutive patients with CSM requiring an anterior decompression were reviewed: 46 patients underwent anterior surgery only (1-to3-level anterior cervical discectomy and fusion [ACDF] or 1-level corpectomy), and 21 patients who required > 3-level ACDF or ≥ 2-level corpectomy underwent anterior surgery supplemented by a posterior instrumented fusion procedure. Results Postoperative improvement in Nurick grade was seen in 43 (93%) of 46 patients undergoing anterior decompression and fusion alone (p < 0.001) and in 17 (81%) of 21 patients undergoing anterior decompression and fusion with supplemental posterior fusion (p = 0.0015). The overall complication rate for this series was 25.4%. Interestingly, the overall complication rate was similar for both the lone anterior surgery and combined anterior-posterior groups, but the incidence of adjacent-segment disease was greater in the lone anterior surgery group. Conclusions Significant improvement in Nurick grade can be achieved in patients who undergo anterior surgery for cervical myelopathy for primarily ventral disease or loss of cervical lordosis. In selected high-risk patients who undergo multilevel ventral decompression, supplemental posterior fixation and arthrodesis allows for low rates of construct failure with acceptable added morbidity.

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Anterior osteophytectomy for cervical spondylotic myelopathy in developmentally narrow canal

Journal of Neurosurgery ◽

10.3171/jns.1985.63.6.0845 ◽

1985 ◽

Vol 63 (6) ◽

pp. 845-850 ◽

Cited By ~ 28

Author(s):

Satoru Kadoya ◽

Tsutomu Nakamura ◽

Ryungchan Kwak ◽

Genjiro Hirose

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Interbody Fusion ◽

Limb Function ◽

Content Type ◽

Upper Limb Function ◽

Canal Stenosis ◽

Grade Classification ◽

Cervical Traction ◽

Developmental Canal Stenosis

✓ The authors present 19 cases of cervical spondylotic myelopathy in patients with developmentally narrow canal treated by microsurgical anterior osteophytectomy with interbody fusion, with follow-up periods of 1 to 8 years (mean 38 months). Postoperatively, the lower limb function, evaluated by Nurick's six-grade classification, improved two or three grades in 16 cases, one grade in two cases, and remained unchanged in one case. The upper limb function, evaluated by the authors' own four-grade classification, improved two or three grades in 11 cases, one grade in seven cases, and remained unchanged in one case. No deterioration caused by the osteophytectomy was seen. During the follow-up period, spondylolisthesis appeared 31 months postoperatively in one patient and soft disc hernia occurred 66 months postoperatively in another; these two patients were treated by a second operation and cervical traction, respectively. The authors conclude that anterior osteophytectomy with interbody fusion is applicable as a surgical treatment of cervical spondylotic myelopathy even where developmental canal stenosis is present.

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