[Cervical myelopathy: retrospective analysis of surgical results in 53 cases treated by anterior cervical discectomy and interbody fusion].
METHODS
We perform a retrospective analysis of clinical results in 53 consecutive patients surgically treated for cervical myelopathy or myelo-radiculopathy with anterior cervical discectomy and interbody fusion by means of the Cloward procedure.


RESULTS
64.2% of the patients had good outcome as measured by the improvement in one or more grades in the Nurick's scale. No mortality related to the surgical procedure was noted, although 9.4% of the cases suffered neurological deterioration. Correct fusion was achieved in 92.5% of the patients, with a rate of post-surgical kyphosis of 9.4%. Multivariate analysis identified as factors related to the clinical outcome: age (p = 0.008), vascular risk factors (p = 0.031), duration of symptoms (p = 0.002), pre-surgical neurological status (p < 0.001), neuroradiological diagnosis (p = 0.014), intra-medullary high signal intensity changes in T2-weighted images (p = 0.008), prolongation of the central somato-sensory or motor conduction times (p = 0.004) and neurologic complications (p = 0.012)


CONCLUSIONS
Treatment optimisation of the patient suffering cervical spondylotic myelopathy requires individualised evaluation. Prospective randomised studies are needed to answer the questions when and how to operate.
Martín
R
R
Servicio de Neurocirugía, Hospital Universitario Marqués de Valdecilla, Santander.
Carda
J R
JR
Montiaga
F
F
Pinto
J I
JI
Sanz
F
F
Paternina
B
B
Trigueros
F
F
Izquierdo
J M
JM
Vázquez-Barquero
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000453:epidemiology / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods* / Q000706:statistics & numerical data; D013128:Spinal Osteophytosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology