Minimally Invasive Microscopic Posterior Cervical Decompression: Simple, Safe, and Effective.
Background and Study AimsCervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM.Materials and MethodsA retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed. The operation was performed through a nonexpandable tubular retractor and operating microscope.ResultsTwelve patients were identified. There were no early or late complications. Average age was 74.5 years. Three patients were > 80 years of age and tolerated the operation extremely well. Three cases were two-level decompressions; nine were single level. Eight patients were operated on as elective cases, with average postoperative length of stay of 0.9 days. Average surgical time was 77.5 minutes per level. Postoperative neck pain was minimal (1.5/10). All patients improved postoperatively, particularly those who started with severe deficits. In fact, five patients were unable to walk preoperatively and were wheelchair- or bed-bound, and they returned to walking within weeks. The modified Japanese Orthopedic Association score improved from 8.4 (range: 4-14) to 13.5 (range: 10-15); the Nurick score changed from 3.8 (range: 2-5) to 2.3 (range: 1-4).ConclusionsMinimally invasive microscopic posterior cervical decompression is a safe and effective treatment for CSM in selected cases. Our initial experience highlights the potential benefits of this relatively new technique.
Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, United Kingdom of Great Britain and Northern Ireland.
Pierluigi
P
Vergara
D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011184:Postoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D016896:Treatment Outcome