Document Detail


A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years.
MedLine Citation:
PMID:  6280455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This paper reviews management by means of the posterior approach of 50 patients with cervical myeloradiculopathy caused by spondylosis and stenosis of the spinal canal seen in the past 10 years. Careful selection of patients is an absolute necessity since a primary cause of failure occurred in individuals who subsequently proved to have motor neurone disease. Older individuals with long-standing neurological deficits, especially long tract signs indicative of fixed lesions, were benefited primarily by a lack of further progression of their disorder and occasional improvement in hand function and gait. Diagnostic evaluation should include electromyography, nerve conduction studies, and sensory evoked cortical potentials. With the introduction of the fourth generation CAT scanning equipment, additional diagnostic information is available regarding the internal configuration of the spinal canal, its contents, and the amount of available space at various levels. Supplementary myelography remains of basic importance. Laminectomy includes two levels above and below the areas of significant canal encroachment. Foraminal decompression with removal of only the innermost third of the foramen permits mobilization of the nerve roots, removal of osteophytes and untethering of the dural sac. A great deal of importance is attached to the preservation of the cervical lordotic curve since, with an adequate decompression and an intact dura, the cord moves dorsally into an expanded canal, rising above the ventrally situated osteophytes. In those patients with reversal of the cervical curve and swan neck deformities, posterior decompression has not been of value. Recent more radical procedures in such cases, such as vertebrectomy, remain to be evaluated. Any procedure which will permit further kyphotic deformity, such as laminectomy, is contraindicated. Eighty-five percent of the patients operated upon by the recommended surgical approach improved.
Authors:
J A Epstein; Y Janin; R Carras; L S Lavine
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  61     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  1982  
Date Detail:
Created Date:  1982-06-24     Completed Date:  1982-06-24     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  89-104     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cervical Vertebrae* / surgery
Female
Humans
Laminectomy*
Male
Middle Aged
Peripheral Nervous System Diseases / surgery
Retrospective Studies
Spinal Cord / surgery*
Spinal Cord Diseases / radiography,  surgery*
Spinal Nerve Roots*
Spinal Osteophytosis / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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