Causes of neurologic deterioration following surgical treatment of cervical myelopathy.
Neurologic deterioration was analyzed in 110 patients with surgically treated cervical myelopathy secondary to soft disc hernia or spondylosis. Follow-up periods ranged from 2 to 14 years, with an average of 6 years. Of 110 patients, 29 suffered neurologic deterioration. In most of the patients, deterioration occurred within the first year after surgery. Causes of deterioration were divided into three categories: direct trauma to neural tissue during surgery (a preventable complication); instability of the spine, progression of spondylotic changes above or below the level of fusion, and non-union (apparently unpreventable but treatable); and nonsurgery-related accidental trauma (unavoidable and often irreversible). Countermeasures for the deterioration are discussed.
D002574:Cervical Vertebrae; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications; D007431:Intraoperative Complications; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009417:Nerve Tissue / Q000293:injuries; D009460:Neurologic Examination; D011183:Postoperative Complications; D013118:Spinal Cord Diseases / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects; D013169:Spondylolysis / Q000150:complications