[Anterior cervical corpectomy in the treatment of multilevel degenerative stenoses with spondylotic myelopathy. Personal experience with therapy and a literature review].
The authors use as a basis experience with a group of 389 patients operated in 1989-1997 on account of degenerative diseases of the cervical spine with neurological manifestations. The results are compared with experience assembled in 1998-1999. In the new group (188 patients with the same diagnosis) the same indication criteria were used but in case of myelopathy associated with multisegmetal cervical stenosis not only multilevel discectomy was performed (as in the previous group) but in addition also 1-3 segmental corpectomy (somatectomy). The results were evaluated separately for both methods used. The authors emphasize the necessity of a radical approach during decompression of neurological structures incl. removal of uncovertebral osteophytes which must be combined with suitable stabilization of the fusions or possibly be supported by instrumentation. In the discussion the authors illustrate in the form of a review the development of anterior cervical corpectomy as one of the methods of an anterior approach to the cervical spine used at first in traumatic and oncological conditions, later extended to operations on account of degenerative, dysplastic conditions and other diseases. The authors wish to help to define criteria for application of corpectomy when treating stenoses of the spinal canal in the cervical region. The indication will be defined in a perspectively followed up group where a detailed clinical and electrophysiological algorithm for examination was submitted as well as postoperative follow-up and processing of the resulting data.
Häckel
M
M
Neurochirurgická klinika 1. LF UK a IPVZ, UVN, Praha.
Stejskal
L
L
Kramár
F
F
D016025:Bone Transplantation; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods; D006801:Humans; D011843:Radiculopathy / Q000209:etiology*; D013117:Spinal Cord Compression / Q000209:etiology*; D013123:Spinal Fusion; D013128:Spinal Osteophytosis / Q000150:complications / Q000601:surgery; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*