Background: Degenerative cervical myelopathy (DCM)
is a nonspecific general term including multiple different
components leading to neurological injury of the cervical
spinal cord due to both static and dynamic mechanisms of
injury both anterior and posterior approaches can be used
during surgery according to situation with successful results.
Aim of Study: This retrospective study was carried out
with the aim of investigating the operative results and factors
affecting outcome for patients withmultilevel cervical disc
herniation with compressive myelopathy with the use of
intraoperative neuro-monitoring.
Patients and Methods: 54 patients with cervical discogenic
myelopathy were operated using anterior cervical discectomy
and interbody fusion (ACDF). Clinical and radiographic
features were reviewed to evaluate the surgical results and
prognostic factors. The clinical outcome was judged using
two grading systems (Herkowitz's scale and Nurick's grade).
Intraoperative neuro-monitoring was used in 32 cases.
Results: Male involvement was more common than female
involvement (3:1), C5-6 level was involved in most cases.
Difficult walking, variable degree of spasticity, paraesthesia
were the most obvious signs. Magnetic resonance (MRI)
images showed that central disc herniation was present in all
cases with signal changes in the cervical cord in 41 cases.
Postoperative, 47 patients showed favourable results (excellent,
good) according to Herkowitz's scale. The use of intraoperative
neuro-monitoring (IOM) did not produce any significant
changes in the outcome regarding postoperative results.
Conclusion: Anterior approach is very efficient for successful surgical treatment of non-traumatic degenerative
cervical spondylotic myelopathy affecting multiple levels
with satisfactory postoperative results, several factors affect
postoperative outcome especially duration of complain and
preoperative neurological status. The use of intraoperative
neuromonitoring is useless. |
