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European Spine Journal

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01-04-2015 | Review

Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation

Author: Kuniyoshi Abumi

Published in: European Spine Journal | Special Issue 2/2015

Abstract

Introduction

Posterior decompression by laminoplasty and anterior decompression/fixation have been widely accepted, and they provide sufficient results for cervical spondylotic myelopathy. However, combined procedure of posterior decompression and reconstruction is favorable for some patients accompanying local kyphosis, segmental instability, previously operated conditions on the cervical spine, etc.

Discussion

Among posterior cervical instrumentations, pedicle screw fixation is a strong tool of stabilization of unstable segment and correction of deformities in sagittal and/or coronal planes for the patient with cervical spondylotic myelopathy. On the other hand, neurovascular complications including injury to the vertebral artery and nerve root cannot be completely eliminated. Even after surgeons became familiar with placement of cervical pedicle screws, screw malposition rate by freehand technique is high for patients with severe spondylotic condition. Surgeons must especially be careful for inserting pedicle screw in the cervical spine associating marked degenerative changes by spondylosis, and must obtain preoperatively sufficient anatomical information of the pedicle and surrounding structures.

Conclusion

Combined procedure of posterior reconstructive surgery using a pedicle screw fixation provides better clinical outcomes than laminoplasty alone for cervical spondylotic myelopathy accompanying local kyphosis or segmental instability. Further development of supporting tools for cervical pedicle screw insertion including aiming device, navigation system and neuromonitoring procedure are expected for safer screw insertion.

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Title: Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation
Author: Kuniyoshi Abumi
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 2/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3838-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cervical spondylotic myelopathy: posterior decompression and pedicle screw fixation

Abstract

Introduction

Discussion

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Discussion

Conclusion

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