Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations
Bajamal Abdul Hafid, 김세훈, Arifianto Mohammad Reza, Faris Muhammad, Subagio Eko Agus, Roitberg Ben, Udo-Inyang Inyang, Belding Jonathan, Zileli Mehmet, Parthiban Jutty K. B. C.,
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( Bajamal Abdul Hafid )
Airlangga University Dr. Soetomo Academic General Hospital Department of Neurosurgery
김세훈 ( Kim Se-Hoon )
Korea University Ansan Hospital Department of Neurosurgery
( Arifianto Mohammad Reza )
Airlangga University Dr. Soetomo Academic General Hospital Department of Neurosurgery
( Faris Muhammad )
Airlangga University Dr. Soetomo Academic General Hospital Department of Neurosurgery
( Subagio Eko Agus )
Airlangga University Dr. Soetomo Academic General Hospital Department of Neurosurgery
( Roitberg Ben )
Case Western Reserve University MetroHealth Medical Center Department of Neurosurgery
( Udo-Inyang Inyang )
Case Western Reserve University MetroHealth Medical Center Department of Neurosurgery
( Belding Jonathan )
Case Western Reserve University MetroHealth Medical Center Department of Neurosurgery
( Zileli Mehmet )
Ege University Department of Neurosurgery
( Parthiban Jutty K. B. C. )
Kovai Medical Center and Hospital Department of Neurosurgery
Abstract
Objective: This study was conducted to determine and recommend the most up-to-date information on the indications, complications, and outcomes of posterior surgical treatments for cervical spondylotic myelopathy (CSM) on the basis of a literature review.
Methods: A comprehensive literature search was performed, using the MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and Web of Science databases, for peer-reviewed articles published in English during the last 10 years.
Results: Posterior techniques, which include laminectomy alone, laminectomy with fusion, and laminoplasty, are often used in patients with involvement of 3 or more levels. Posterior decompression for CSM is effective for improving patients’ neurological function. Complications resulting from posterior cervical spine surgery include injury to the spinal cord and nerve roots, complications related to posterior screw fixation or instrumentation, C5 palsy, spring-back closure of lamina, and postlaminectomy kyphosis.
Conclusion: It is necessary to consider multiple factors when deciding on the appropriate operation for a particular patient. Surgeons need to tailor preoperative discussions to ensure that patients are aware of these facts. Further research is needed on the cost-to-benefit analysis of various surgical approaches, the comparative efficacy of surgical approaches using various techniques, and long-term outcomes, as current knowledge is deficient in this regard.
키워드
Cervical spondylosis; Compressive myelopathy; Laminoplasty; Laminectomy; Complications; Outcomes assessment
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