Gregory C Wiggins1, Christopher I Shaffrey. 1. Department of Neurosurgery, David Grant Medical Center, Travis Air Force Base, California 94535-1800, USA. greg.wiggins@travis.af.mil
Abstract
OBJECTIVE: To review the dorsal approaches to the cervical spine for myelopathy and myeloradiculopathy. METHODS: The literature was reviewed in reference to dorsal approaches for cervical myelopathy and myeloradiculopathy. RESULTS: There are a variety of surgical approaches in the management of cervical myelopathy and myeloradiculopathy. Deciding which is the best method for any individual requires the surgeon to be aware of the advantages of each technique, as well as the complications and limitations of each approach. CONCLUSION: Laminectomy is the traditional technique used for multilevel cervical stenosis. The complications related to laminectomy, such as late neurological decline, kyphosis, instability, and postoperative radiculopathy, led to laminectomy with fusion. In Japan, dissatisfaction with both laminectomy and laminectomy with fusion led to the development of laminoplasty for dorsal treatment of multilevel cervical stenosis. This article highlights the salient features of preoperative evaluation in this patient population as it pertains to dorsal surgical approaches. Additionally, the techniques of laminectomy, laminectomy with fusion, and laminoplasty are compared, and the results are reviewed.
OBJECTIVE: To review the dorsal approaches to the cervical spine for myelopathy and myeloradiculopathy. METHODS: The literature was reviewed in reference to dorsal approaches for cervical myelopathy and myeloradiculopathy. RESULTS: There are a variety of surgical approaches in the management of cervical myelopathy and myeloradiculopathy. Deciding which is the best method for any individual requires the surgeon to be aware of the advantages of each technique, as well as the complications and limitations of each approach. CONCLUSION: Laminectomy is the traditional technique used for multilevel cervical stenosis. The complications related to laminectomy, such as late neurological decline, kyphosis, instability, and postoperative radiculopathy, led to laminectomy with fusion. In Japan, dissatisfaction with both laminectomy and laminectomy with fusion led to the development of laminoplasty for dorsal treatment of multilevel cervical stenosis. This article highlights the salient features of preoperative evaluation in this patient population as it pertains to dorsal surgical approaches. Additionally, the techniques of laminectomy, laminectomy with fusion, and laminoplasty are compared, and the results are reviewed.
Authors: Giuseppe M V Barbagallo; Roberto Assietti; Leonardo Corbino; Giuseppe Olindo; Pietro V Foti; Vittorio Russo; Vincenzo Albanese Journal: Eur Spine J Date: 2009-05-05 Impact factor: 3.134