Abstract

MARTIN, R. et al. Cervical myelopathy: retrospective analysis of surgical results in 53 cases treated by anterior cervical discectomy and interbody fusion. Neurocirugía [online]. 2005, vol.16, n.3, pp.235-255. ISSN 1130-1473.

Patients and methods. We perform a retrospective analysis of clinical results in 53 consecutive patients surgically treated for cervical myelopathy or myelo-radiculopathy with anterior cervical discectomy and interbody fusion by means of the Cloward procedure.   Results. 64.2% of the patients had good outcome as measured by the improvement in one or more grades in the Nurick´s scale. No mortality related to the surgical procedure was noted, although 9.4% of the cases suffered neurological deterioration. Correct fusion was achieved in 92.5% of the patients, with a rate of post-surgical kyphosis of 9.4%. Multivariate analysis identified as factors related to the clinical outcome: age (p=0.008), vascular risk factors (p=0.031), duration of symptoms (p=0.002), pre-surgical neurological status (p<0.001), neuroradiological diagnosis (p=0.014), intra-medullary high signal intensity changes in T2-weighted images (p=0.008), prolongation of the central somato-sensory or motor conduction times (p=0.004) and neurologic complications (p=0.012)   Conclusions. Treatment optimisation of the patient suffering cervical spondylotic myelopathy requires individualised evaluation. Prospective randomised studies are needed to answer the questions when and how to operate.

Keywords : Cervical discectomy; Cervical disc herniation; Cervical myelopathy; Interbody fusion.

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