Deglutition Disorders ; surgery ; Dyspnea ; surgery ; Humans ; Spondylosis

Humans ; Manipulation, Spinal ; methods ; Spondylosis ; surgery ; therapy

Cervical Vertebrae ; surgery ; Humans ; Spondylosis ; classification ; diagnosis ; surgery

Cervical Vertebrae ; surgery ; Humans ; Orthopedic Procedures ; methods ; Spinal Cord Diseases ; surgery ; Spondylosis ; surgery

There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.
Cervical Vertebrae ; surgery ; Decompression, Surgical ; Humans ; Spondylosis ; diagnosis ; surgery ; Treatment Outcome

Cervical Vertebrae/surgery* ; Esophagus ; Humans ; Spinal Fusion ; Spinal Osteophytosis ; Spondylosis/surgery*

OBJECTIVETo investigate the clinical effects of anterior cervical intervertebral space decompression under microscope in treating cervical spondylotic myelopathy in elderly patients.

METHODSFrom June 2009 to March 2012, 43 patients with cervical spondylotic myelopathy were treated with anterior cervical intervertebral space decompression and intervertebral fusion under microscope. There were 26 males and 17 females, aged from 60 to 72 years old with an average of (64.9±3.7) years. Japanese Orthopaedic Association System (JOA) score was from 7 to 12 points with an average of (9.5±1.8) points before operation. The function of nerves was assessed before and after operation according to JOA.

RESULTSAll patients were followed up from 10 to 18 months with an average of (14.7±1.6) months. Postoperative JOA score was (13.81±1.44) points (ranged, 10 to 16), had significantly higher than preoperative (P<0.01). According to the rate of the improved JOA score, 9 cases got excellent results, 26 good, 7 fair, 1 poor.

CONCLUSIONAnterior cervical intervertebral space decompression under microscope for cervical spondylotic myelopathy in elderly patients is safe and effective.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Microscopy ; Middle Aged ; Spondylosis ; surgery

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; surgery ; Treatment Outcome

OBJECTIVETo discuss on the effect of cervical spondylotic myelopathy before and after surgery and assess its indications and efficacy.

METHODSFrom June 2002 to June 2006, 125 patients with cervical spondylotic myelopathy were analyzed retrospectively involving 58 anterior routine and 67 posterior routine, of which 71 cases of males, 54 cases of females, aged from 28 to 69 years (average 53.4 years). The course was 0.5 to 48 months (means 14 months). According to JOA score system preoperative and postoperative nerve function were analyzed, summarized anterior and posterior cervical spine surgery.

RESULTSAll patients were followed up for from 6 to 30 months (average of 18 months). According to JOA score criteria: anterior cervical surgery preoperative JOA score was (8.78 +/- 2.43) points, postoperative JOA score was (14.68 +/- 2.37) points, the results were excellent in 40 cases, good in 10 cases, effective in 6. Posterior surgical group preoperative JOA score was (8.49 +/- 2.58) points, postoperative JOA score was (14.26 +/- 2.83) points, the results were excellent in 42 cases, good in 12 cases, effective in 8. Invalid operation occurrenced in 6 cases included 2 of anterior, 4 of posterior. The postoperative symptoms had worsed in 1 case of posterior operation. The two groups had no statistical difference in efficacy, but there were differences statistically in the same approach comparing preoperative and postoperative.

CONCLUSIONBoth anterior and posterior approaches have fine effect to the treatment of cervical spondylotic myelopathy (CSM). But the selection of the indication is very important, the patients with the pressure from anterior, the short-level changes, and the main symptoms of pyramid trac compression, adopt anterior approach on principle. While the patients with the pressure of spinal cord from posterior, multilevel changes, main symptoms of sensory disturbances, and accompanied by cervical spine canal stenosis mainly is introduced posterior approach.

Adult ; Aged ; Cervical Vertebrae ; physiopathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spondylosis ; physiopathology ; surgery

The "Clinical Guidelines for Diagnosis and Treatment of Cervical Spondylotic Myelopathy with the Integrated Traditional Chinese and Western Medicine" were formulated by the Orthopedic and Traumatology Professional Committee of the Chinese Association of Integrative Medicine in accordance with the principles of evidence-based medicine and expert consensus, and provide clinicians with academic guidance on clinical diagnosis and treatment of CSM. The main content includes diagnostic points, disease grading assessment, TCM syndrome differentiation, surgical indications and timing, integrated traditional Chinese and Western medicine treatment, and postoperative rehabilitation. This guideline proposes for the first time that the treatment of CSM should follow the principle of grading, clarify the timing and methods of surgical treatment, establish common TCM syndrome differentiation and classification, attach importance to postoperative integrated rehabilitation of Chinese and Western medicine, and strengthen daily follow-up management. It hopes to promote the standardization, effectiveness, and safety of clinical treatment of CSM.
Humans ; Spinal Cord Diseases/surgery* ; Cervical Vertebrae/surgery* ; Medicine, Chinese Traditional ; Integrative Medicine ; Spinal Osteophytosis ; Spondylosis/surgery*