Anterior Reconstructive Procedures in Cervical Spondylotic Myelopathy

Park, Hyang Kwean; Park, Dong Been

Abstract

The degenerative process of cervical spondylosis through acquired narrowing of the spinal canal or segmental hypermobility of the spinal column, either singularly or in combination, mayresult in injury to the spinal cord or supportive vasculature. The mutifactional character of cervical spondylotic myelopathy(CSM) indicates a probable onset and progression of this disease aswell as a diversity of clinical manifestations. Although it is recognized that a number of factors,mostly vascular, may contribute to the pathogenesis of CSM, surgical procedures performed forthis condition decompress the spinal cord on the premise that mechanical compression is a major, if not pirmary, causative factor. For several decades, both anterior and posterior spinal decompressive procedures have beenperformed on CSM patients, who are generally being informed before the operation that theaim of surgery is to stabilize their neurologic condition and that actual improvement often cannot be expected. Over the past 10 years, radical cervical cord decompression via corpectomy has been reportedas being more effective than conventional surgery for CSM. The authors have undertaken a study of 12 patients who underwent anterior decompreuivecorpectomy procedures for CSM, which was defined as a myelopathy related to osteophyticovergrowth and ossification of posterior longitudinal ligament(OPLL) in the conical spinal canal causing impingement upon the spinal cord from Mar, 93 to Aug. 95 at Dong Dae MoonHospital, Department of Neurosurgery. The result was fo11owing : man was prevalent in allcases, prognosis was strongly correlated with age, preoperative neurological state and 7 cases(58%) resulted in excellent group.