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PROGRESSION OF MYELOPATHY TREATED WITH CORPECTOMY, AUTOLOGOUS GRAFT AND PLATE

EVOLUÇÃO DA MIELOPATIA TRATADA COM CORPECTOMIA, ENXERTO AUTÓLOGO E PLACA

EVOLUCIÓN DE LA MIELOPATÍA MANEJADA CON CORPECTOMÍA, INJERTO AUTÓLOGO Y PLACA

ABSTRACT

Introduction:

Cervical myelopathy is a degenerative pathology of spinal and/or root involvement. Caused by hypertrophy of the yellow ligament, osteophytes in the medullary canal and disc herniation. It affects the upper and lower motor neurons. The treatment of myelopathy diagnosed by magnetic resonance and electromyography consists of decompression by corpectomy.

Methods:

Autologous graft integration with cervical plate placement was evaluated in 31 patients, from January 1, 2013 to December 31, 2015. The procedure consisted of a Smith Robinson approach, anterior corpectomy, iliac crest autograft, anterior stabilization with cervical plate (Vectra, Synthes). Statistical analysis was performed with EPIINFO 3.5.1. Results: Age 64.6% (45-65 years), Sex: 41.9% (women), 58.1% (men). Segments treated: 38.7% (C5-C6), 35.5% (C4-C5), graft separation in sections <0.5 cm, sagittal, and <0.5 cm, axial at 12 months. Bleeding 61.3% (100-500 ml), 32.3% (501-100 ml), 6.5% (1,001-1,500 ml). Time 32.3% (> 249 min), 32.3% (121-180 min), 32.3% (181-240 min), 3.2% (91-120 min).

Discussion:

In this series, Querétaro is similar to other cities in the world with respect to sex, age, levels affected, number of complications, surgical time and bleeding, as well as graft integration in the evaluation at 12 months.

Conclusions:

Increased frequency in adult men, C4-C6 affected levels; Complications: recurrent laryngeal nerve injury, bleeding greater than 500 ml.

Keywords:
Spinal cord diseases; Prognosis; Treatment outcome.

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