J Korean Soc Spine Surg.  1998 Nov;5(2):293-300.

The Treatment of Cervical Myelopathy

• Kim YT
• Lee CS
• Na HY
• Cha YC

Abstract

STUDY DESIGN: We retrospectively reviewed the cervical myelopathy patients who underwent anterior or posterior surgery.
OBJECTIVES
This study was undertaken to analyze the preoperative radiologic evaluation and the results of the treatment of cervical myelopathy. SUMMARY OF LITERATURE REVIEW: The surgical treatment of cervical myelopathy consisted of anterior/posterior or combined surgery according to lesion site, symptoms, number of involved sequents or prevalence of the surgeon. Material and
METHODS
We reviewed the clinical and radiological aspects of 28 patients Preoperative plain radiographs and MRI were evaluated with clinical symptoms. Postoperative clinical evaluation was performed according to the Robinson's criteria.
RESULTS
On plain lateral radiographs, spinal canal diameter were 13.4+/-2.6/12.5+/- 1.7mm, Pavlovratios were 0.78+/-0.09/0.66+/-0.08, spondylosis indices were 1.70/1.80mm, and the antero-posterior compression ration of spinal cord were 42.4+/-8/44.0+/-6% for anterior surgery and posterior surgery group each. The results of 15 patients who received anterior decompression and interbody fusion were excellent in 11, good in 2, and fair in 2 cases. The results of 13 patients who underwent laminoplasty were excellent in 9, good in 3, and fair in one case.
CONCLUSIONS
The patients who have Pavlov ratio less than 0.8 and spondylosis index more than 1.5mm on plain radiograph are vulnerable to developing myelopathy. It is better to do anterior decom pression and interbody fusion in patients who have one or two segments involved and kyphotic deformity of the cervical spine. Otherwise, patients who involve more than 3 segments and narrow spinal canal can be managed using laminoplasty posteriorly.

MeSH Terms

Congenital Abnormalities
Decompression
Humans
Magnetic Resonance Imaging
Prevalence
Retrospective Studies
Spinal Canal
Spinal Cord
Spinal Cord Diseases*
Spine
Spondylosis