OBJECT: Cervical spondylotic myelopathy (CSM) is a common cervical degenerative disease that affects the elderly population. Spinal cord decompression is achieved through various anterior and posterior approaches including anterior cervical decompression and fusion, laminectomy, laminoplasty, and combined approaches. The authors describe another option, minimally invasive endoscopically assisted decompression of stenosis (MEDS), which obviates the need for muscle dissection and disruption of the posterior tension band, a cause of postlaminectomy kyphosis. METHODS: The authors conducted a retrospective study of 10 patients with CSM who underwent MEDS from January 2002 through July 2012. Data were collected on demographics, preoperative and postoperative Nurick scores, postoperative Odom scores, and preoperative and postoperative Cobb angles. RESULTS: The mean patient age (± SD) was 67 ± 7.7 years; 8 patients were male. The average number of disc levels operated on was 2.2 (range 1-4). The mean Nurick score was 1.6 ± 0.7 preoperatively and improved to 0.3 ± 0.7 postoperatively (p < 0.0005). The postoperative Odom scores indicated excellent outcomes for 4 patients, good for 3, fair for 2, and poor for 1. The average preoperative focal Cobb angle at the disc levels operated on was -0.43º ± 1.9º. The average Cobb angle at the last follow-up visit was 0.25° ± 1.6° (p = 0.6). The average follow-up time was 18.9 ± 32.1 months. There were no intraoperative or postoperative complications. CONCLUSIONS: For selected patients with CSM, whose pathologic changes are primarily posterior and who have acceptable preoperative lordosis, MEDS is an alternative to open laminectomy and laminoplasty.
OBJECT: Cervical spondylotic myelopathy (CSM) is a common cervical degenerative disease that affects the elderly population. Spinal cord decompression is achieved through various anterior and posterior approaches including anterior cervical decompression and fusion, laminectomy, laminoplasty, and combined approaches. The authors describe another option, minimally invasive endoscopically assisted decompression of stenosis (MEDS), which obviates the need for muscle dissection and disruption of the posterior tension band, a cause of postlaminectomy kyphosis. METHODS: The authors conducted a retrospective study of 10 patients with CSM who underwent MEDS from January 2002 through July 2012. Data were collected on demographics, preoperative and postoperative Nurick scores, postoperative Odom scores, and preoperative and postoperative Cobb angles. RESULTS: The mean patient age (± SD) was 67 ± 7.7 years; 8 patients were male. The average number of disc levels operated on was 2.2 (range 1-4). The mean Nurick score was 1.6 ± 0.7 preoperatively and improved to 0.3 ± 0.7 postoperatively (p < 0.0005). The postoperative Odom scores indicated excellent outcomes for 4 patients, good for 3, fair for 2, and poor for 1. The average preoperative focal Cobb angle at the disc levels operated on was -0.43º ± 1.9º. The average Cobb angle at the last follow-up visit was 0.25° ± 1.6° (p = 0.6). The average follow-up time was 18.9 ± 32.1 months. There were no intraoperative or postoperative complications. CONCLUSIONS: For selected patients with CSM, whose pathologic changes are primarily posterior and who have acceptable preoperative lordosis, MEDS is an alternative to open laminectomy and laminoplasty.
Authors: Christoph P Hofstetter; Yong Ahn; Gun Choi; J N A Gibson; S Ruetten; Yue Zhou; Zhen Zhou Li; Christoph J Siepe; Ralf Wagner; Jun-Ho Lee; Koichi Sairyo; Kyung Chul Choi; Chien-Min Chen; A E Telfeian; Xifeng Zhang; Arun Banhot; Pramod V Lokhande; N Prada; Jian Shen; F C Cortinas; N P Brooks; Peter Van Daele; Vit Kotheeranurak; Saqib Hasan; Gun Keorochana; Mohammed Assous; Roger Härtl; Jin-Sung Kim Journal: Global Spine J Date: 2020-05-28
Authors: Ricardo Rodrigues-Pinto; Thiago S Montenegro; Benjamin M Davies; So Kato; Yoshiharu Kawaguchi; Manabu Ito; Mehmet Zileli; Brian K Kwon; Michael G Fehlings; Paul A Koljonen; Shekar N Kurpad; James D Guest; Bizhan Aarabi; Vafa Rahimi-Movaghar; Jefferson R Wilson; Mark R N Kotter; James S Harrop Journal: Global Spine J Date: 2022-02