Cervical Spondylotic Myelopathy: When and Why the Cervical Corpectomy?

• Published in: World neurosurgery Vol. 140; pp. 548 - 555
• Main Authors: Pescatori, Lorenzo, Tropeano, Maria Pia, Visocchi, Massiliano, Grasso, Giovanni, Ciappetta, Pasqualino
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020
• Subjects: Adult; Aged; Cervical corpectomy; Cervical spondylotic myelopathy; Cervical Vertebrae - surgery; Decompression, Surgical - methods; Degenerative cervical myelopathy; Female; Functional Status; Humans; Intervertebral Disc Degeneration - complications; Intervertebral Disc Degeneration - physiopathology; Intervertebral Disc Degeneration - surgery; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - physiopathology; Intervertebral Disc Displacement - surgery; Male; Middle Aged; Ossification of Posterior Longitudinal Ligament - complications; Ossification of Posterior Longitudinal Ligament - physiopathology; Ossification of Posterior Longitudinal Ligament - surgery; Prospective Studies; Severity of Illness Index; Spinal Cord Compression - etiology; Spinal Cord Compression - physiopathology; Spinal Cord Compression - surgery; Spinal Fusion; Spondylosis - complications; Spondylosis - physiopathology; Spondylosis - surgery; Surgical outcomes; Treatment Outcome; Young Adult; Surgical outcomes; Degenerative cervical myelopathy; Cervical corpectomy; MEP; CSM; mJOA; Cervical spondylotic myelopathy
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2020.03.100

Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The best treatment option has remained controversial. We performed a prospective study to evaluate the clinical, radiographic, and neurophysiologic outcomes for anterior cervical corpectomy in the treatment of CSM. From January 2011 to January 2017, 60 patients with CSM were prospectively enrolled in the present study. The patients were divided according to the modified Japanese Orthopaedic Association scale (mJOA) score into 2 groups: group A, patients with mild to moderate CSM (mJOA score ≥13); and group B, patients with severe myelopathy (mJOA score <13). Data were collected for each participating subject, including demographic information, symptoms, medical history, radiologic and neurophysiologic features, and functional impairment. Of the 60 patients, 35 were men (58.3%) and 25 were women (41.7%). Their average age was 57.48 ± 10.60 years. The mean symptom duration was 25.33 ± 16.00 months; range, 3–57 months). Of the 60 patients, 22 had undergone single-level corpectomy and 36 multilevel corpectomy. A significant improvement in the motor evoked potentials was observed in both groups. Single- and multilevel corpectomy are valid and safe options in the treatment of CSM. In the present prospective study, a statistically significant improvement in the mJOA score and neurophysiologic parameters was observed for both moderate and severe forms of CSM.