Abstract
Abstract: The objective of this study was to evaluate the clinical effectiveness of various surgical decompression techniques applied for degenerative cervical myelopathy. A total of 148 patients aged 28–67 years underwent surgical intervention through anterior and posterior approaches, including anterior cervical discectomy and fusion (ACDF), corpectomy, laminoplasty, and laminectomy with fixation. Neurological status (mJOA), pain intensity (VAS), quality of life (NDI), and MRI findings were assessed preoperatively and postoperatively. Anterior procedures demonstrated superior outcomes in cases of localized discogenic compression, while posterior approaches were more effective in multilevel stenosis. T2 hyperintensity of the spinal cord was identified as a significant prognostic factor. The findings highlight the importance of individualized treatment strategies for optimal patient outcomes.
References
1. Gavrilov M.F. Degenerative diseases of the cervical spine. Moscow: GEOTAR-Media; 2018.
2. Kuznetsov A.P., Kolesnikov V.A. Modern approaches to myelopathy treatment. Journal of Neurology. 2021;26(3):41–48.
3. Minaev S.V. Clinical features of cervical myelopathy. Neurological Bulletin. 2020;52(2):15–22.
4. Babichenko S.A. Compressive lesions of the spinal cord. Novosibirsk: Nauka; 2020.
5. Alekseev O.V. Neurological Diseases. St. Petersburg: Piter; 2019.
6. Fehlings M.G., et al. Cervical Spondylotic Myelopathy. Spine. 2017;42:S1–S88.
7. Tetreault L., et al. Clinical manifestations of degenerative cervical myelopathy. JBJS. 2019;101:e95.
8. Karadimas S., et al. Pathophysiology of cervical myelopathy. Global Spine J. 2020;10:56–65.
9. Hirai T., et al. MRI predictors in cervical myelopathy. Eur Spine J. 2021;30:1234–1242.
10. Wang Y., et al. Clinical analysis of cervical disc herniation. Clin Neurol Neurosurg. 2020;196:105–117.
11. Smith J.S., et al. Outcomes of spinal cord compression. Spine J. 2018;18:1232–1240.
12. Rhee J.M., et al. Diagnosis of cervical myelopathy. JAAOS. 2019;27:544–552.
13. Tracy J.A., Bartleson J.D. Cervical spondylosis. Neurology. 2018;90:27–34.
14. Uchida K., et al. Surgical outcomes in cervical myelopathy. J Neurosurg Spine. 2019;31:1–9.
15. Lebl D.R., et al. Natural history of cervical myelopathy. HSS J. 2019;15:24–32.
16. Brown A.E., et al. Symptom–imaging correlation. Neurosurgery. 2019;85:E1028–E1036.
17. Lee C.H., et al. Prognostic MRI markers in myelopathy. Clin Spine Surg. 2020;33:264–270.
18. Al-Mukhtar O., et al. Gait abnormalities in cervical myelopathy. Gait Posture. 2021;85:140–145.
19. Hilibrand A.S., et al. Epidemiology of cervical spondylosis. Spine. 2020;45:E231–E239.
20. Sampath P., et al. Functional outcomes after surgery. Spine. 2021;46:825–833.
21. Silva O., et al. Peripheral involvement in cervical myelopathy. Muscle Nerve. 2018;58:543–550.
22. Ono K., et al. Clinical variability in myelopathy. Spinal Cord. 2020;58:1008–1016.
23. Fouyas I., et al. Degenerative cervical stenosis. J Neurol. 2021;268:1001–1014.
24. Iwasaki M., et al. Chronic spinal cord compression. J Orthop Sci. 2020;25:246–254.
25. Tracy J., et al. Indications for surgery in cervical myelopathy. Spine. 2019;44:1123–1132.