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Coluna/Columna

Print version ISSN 1808-1851

Abstract

MELUZZI, Alexandre et al. Evaluation of surgical techniques for treatment of cervical spondylotic myeloradiculopathy. Coluna/Columna [online]. 2012, vol.11, n.1, pp. 42-51. ISSN 1808-1851.  http://dx.doi.org/10.1590/S1808-18512012000100009.

OBJECTIVE: To evaluate the efficacy of surgical treatment of cervical spondylotic myeloradiculopathy in the production of postoperative neurological improvement, measured in points by the scale of JOA (Japanese Orthopaedic Association) and the recovery rate and complications of therapy. METHODS: Analysis of medical records and imaging studies of 200 patients undergoing surgical treatment of cervical myeloradiculopathy in HC-FMUSP, from January 1993 to January 2007. Clinical evaluation was quantified by the scale of the JOA, with an average follow-up of 6 years and 8 months. RESULTS: There was post-operative neurological improvement in the anterior and posterior approach, except in laminectomy without fusion, where late neurological deterioration was observed. The anterior approach showed a significantly higher rate of complications related to poor fusion, intervertebral displacement of the graft, adjacent disc syndrome, dysphonia, dysphagia, poor positioning of the graft and plates, nerve root injury and significant higher rate of re-operation. In the posterior approach, increased occurrence of instability and kyphosis in the postoperative, in laminectomy were found, whereas in laminoplasty these conditions were not observed, presenting similar rates to those found for the anterior approach. There was no improvement in axial pain in the laminoplasties and worsening in laminectomies, whereas in discectomias and corpectomias there was significant relief of symptoms. CONCLUSION: The anterior and posterior routes were effective in producing neurological improvement, except for laminectomy without fusion. The anterior approach produced more complications, but is better for pain treatment.

Keywords : Diseases of the spinal cord [Myelopathy]; Intervertebral disc; Laminectomy.

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