Multisegmental spondylotic cervical myelopathy treated by longitudinal medial corporectomy without fusion

Abstract

Introduction: The treatment of cervical spondylosis may be medical, surgical or both. Surgical treatment is indicated mainly in patients with untreatable pain, progressive neurological deficit and proven compression of the nerve roots and spinal cord. Corporectomy with a graft and fusion is one of the most widely used techniques carried out by neurosurgeons and orthopaedic surgeons using an anterior approach.

Patients and methods: Between January 1993 and December 2000, six patients aged between 62 and 75 years, with a median age of 68.5 years, clinically and radiologically diagnosed as having multisegmental spondylotic cervical myelopathy, had surgical operations involving corporectomies without grafts. Nurick s scale was used to classify symptoms and radiological assessment was done before and after operation using plain Xrays, three dimensional computerized tomography and magnetic resonance. In one case one corporectomy was done, in two cases two and in three cases three.

Results: The patients follow up varied from 3 months to seven years. In four patients symptoms improved, two became stable and in no case was there any radiological sign of vertebral instability. As far as we know after reviewing the literature, this is the first time that this technique has been published.

Conclusions: Corporectomy without grafting is a new, simple, effective technique for the treatment of multisegmental spondylotic cervical myelopathy.