![]() | Related Articles |
Surgical therapy of multilevel cervical spondylosis in sufferers with or with out a historical past of syringomyelia.
Eur Backbone J. 2017 Apr;26(four):948-957
Authors: Klekamp J
Summary
PURPOSE: Cervical spondylotic myelopathy (CSM) is the most common spinal wire illness in adults. This paper compares sufferers who developed CSM after profitable therapy of syringomyelia to these with CSM solely associated to degenerative spinal illness.
METHODS: On this potential research, 70 consecutive sufferers with CSM and spondylotic adjustments in at the least three ranges underwent 73 operations between 2005 and 2015 (imply follow-up: 39 ± 36 months). Sufferers with handled syringomyelia (group A, n = 30) and people with out (group B, n = 40) have been distinguished. Japanese Orthopaedic Affiliation (JOA) and European Myelopathy scores (EMS), Karnofksy scores, and scores for particular person signs have been in contrast. Lengthy-term outcomes have been analyzed with progression-free survival charges.
RESULTS: Sufferers of group A have been considerably youthful with a considerably longer historical past and decrease practical scores in comparison with group B. 59 laminectomies C3-C6 plus lateral mass fixations, six ventral decompressions with fusion, and eight mixed approaches have been carried out. In each teams, imply JOA (A 9.5 ± four.Three-10.zero ± four.7; B 11.Three ± Three.7-12.Three ± four.Three), EMS (A 11.four ± 2.9-12.zero ± Three.1; B 12.2 ± Three.1-13.5 ± Three.Three), and Karnofsky scores (A 59 ± 18-62 ± 18; B 68 ± 13-72 ± 15) elevated within the first postoperative yr with decrease scores in group A all through. Charges for progression-free survival for five years have been comparable in each teams (A 64.2%, B 65.6%).
CONCLUSION: Sufferers with CSM profit from decompressive surgical procedure. Surgical procedure needs to be advocated early for all symptomatic sufferers with a historical past of syringomyelia. These sufferers are in danger for diagnostic delay and worse postoperative outcomes.
PMID: 28190207 [PubMed – indexed for MEDLINE]