Anterior approaches for cervical spondylotic myelopathy: Which? When? How?

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• 作者：Sanford E. Emery (1)
  
  1. Department of Orthopaedics ; West Virginia University ; PO Box 9196 ; Morgantown ; WV ; 26506-9196 ; USA
  
• 关键词：Cervical myelopathy ; Anterior approach cervical spine ; Anterior cervical discectomy and fusion ; Anterior cervical corpectomy and fusion
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：24
• 期：2-supp
• 页码：150-159
• 全文大小：342 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Cervical spondylotic myelopathy is a degenerative disorder with an unfavorable natural history. Surgical treatment options have evolved substantially over time, with both anterior and posterior methods proving successful for certain patients with specific characteristics. Anterior decompression of the spinal canal plus fusion techniques for stabilization has several advantages and some disadvantages when compared to posterior options. Understanding the pros and cons of the approaches and techniques is critical for the surgeon to select the best operative treatment strategy for any given patient to achieve the best outcome. Multiple decision-making factors are involved, such as sagittal alignment, number of levels, shape of the pathoanatomy, age and comorbidities, instability, and pre-operative pain levels. Any or all of these factors may be relevant for a given patient, and to varying degrees of importance. Choice of operative approach will therefore be dependent on patient presentation, risks of that approach for a given patient, and to some degree surgeon experience.