V Chang1, L T Holly. 1. Department of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, CA, USA - lholly@mednet.ucla.edu.
Abstract
AIM: Cervical spondylotic myelopathy (CSM) is a common clinical entity that can be a significant cause of disability in the adult population. Although our CSM knowledge has markedly grown in recent years, a variety of controversies exist regarding the optimal treatment strategies. The goal of this paper is to review and discuss current areas of controversy in the management of CSM patients. METHODS: Topics addressed in this manuscript include: operative versus nonoperative management for patients with mild CSM, optimal surgical approaches for CSM, the utility of intraoperative monitoring, and radiographical prognostic indicators for outcome following surgery for CSM. RESULTS: A current review reveals several areas where Class I evidence exists regarding these controversies. However, many other studies consist contain Class III or weaker data, thereby making it difficult to draw any definitive conclusions. Despite the lack of a consensus in some areas, it appears that CSM patients can often achieve satisfactory treatment through a variety of different options. CONCLUSION: CSM remains a challenging clinical problem where several areas of controversy still exist. Large, multi-center, randomized prospective trials will be required to help resolve some of the controversies.
AIM: Cervical spondylotic myelopathy (CSM) is a common clinical entity that can be a significant cause of disability in the adult population. Although our CSM knowledge has markedly grown in recent years, a variety of controversies exist regarding the optimal treatment strategies. The goal of this paper is to review and discuss current areas of controversy in the management of CSM patients. METHODS: Topics addressed in this manuscript include: operative versus nonoperative management for patients with mild CSM, optimal surgical approaches for CSM, the utility of intraoperative monitoring, and radiographical prognostic indicators for outcome following surgery for CSM. RESULTS: A current review reveals several areas where Class I evidence exists regarding these controversies. However, many other studies consist contain Class III or weaker data, thereby making it difficult to draw any definitive conclusions. Despite the lack of a consensus in some areas, it appears that CSM patients can often achieve satisfactory treatment through a variety of different options. CONCLUSION: CSM remains a challenging clinical problem where several areas of controversy still exist. Large, multi-center, randomized prospective trials will be required to help resolve some of the controversies.
Authors: Feifei Zhou; Shuyang Li; Yilong Zhang; Yanbin Zhao; Kevin L Ju; Fengshan Zhang; Shengfa Pan; Yu Sun Journal: Health Qual Life Outcomes Date: 2020-10-22 Impact factor: 3.186