Surgical management of cervical myelopathy: indications and techniques for multilevel cervical discectomy.
BACKGROUND
Surgery is usually required for treatment of cervical myelopathy to decompress the neural elements, restore lordosis, and stabilize the spine. By addressing these problems, the neurological deterioration may be halted.


OBJECTIVE
Multilevel cervical discectomy and fusion offers several advantages over other approaches. The authors describe the technique, discuss the indications, and present the potential complications associated with it.


METHODS
Decompression is achieved via discectomy and subsequent removal of the osteophytes using a curetting technique. Preparation of end plates in a parallel fashion allows for gapless grafting of allograft bone for enhancement of fusion. A dynamic plate and screw system strengthens the construct.


RESULTS
A high rate of fusion can be obtained using the technique of multilevel cervical discectomy and fusion with acceptable levels of complications. It is especially useful in cases of spondylosis that have a kyphotic deformity because, in addition to anterior decompression, it allows reconstruction of the spine to help restore a lordotic curvature.


CONCLUSIONS
Multilevel cervical discectomy and fusion has proven to be very effective in decompressing and stabilizing the spine for treatment of cervical myelopathy.
Hillard
Virany H
VH
Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
Apfelbaum
Ronald I
RI
D001860:Bone Plates; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D017586:Diskectomy / Q000379:methods*; D006801:Humans; D007085:Ilium / Q000637:transplantation; D013118:Spinal Cord Diseases / Q000601:surgery*; D013123:Spinal Fusion