magazinelogo

International Journal of Clinical and Experimental Medicine Research

ISSN Print: 2575-7989 Downloads: 161417 Total View: 2139113
Frequency: quarterly ISSN Online: 2575-7970 CODEN: IJCEMH
Email: ijcemr@hillpublisher.com
Article http://dx.doi.org/10.26855/ijcemr.2023.07.026

Surgical Treatment of Cervical Spondylotic Myelopathy

Senyuan Chen1, Ziqiao Zhang1, Runfu Chen1, Rongping Zhou1,2,*

1Medical College of Nanchang University, Nanchang, Jiangxi, China.

2Department of Spine Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

*Corresponding author: Rongping Zhou

Published: August 21,2023

Abstract

Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord injury in adults. The typical symptoms of CSM are poor hand dexterity and unsteady gait pattern, which prevent patients from completing fine movements, seriously affecting their quality of life. Surgical treatment is generally recommended for patients who have moderate to severe CSM and who have received conservative treatment but whose symptoms are still progressing. However, the choice of surgical method has been controversial due to the diversity of surgical procedures of CSM. For spine surgeons, understanding the features of different procedures can greatly assist them in making clinical decisions. Based on the different approaches, operative treatments can be grouped into anterior surgery, posterior surgery, and combined anterior and posterior surgery. Anterior surgeries include anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), as well as cervical disc replacement (CDR). Posterior surgeries consist of laminectomy and laminoplasty. For patients with a complex pathophysiology and more severe CSM, combined anterior-posterior surgery, such as posterior laminoplasty or laminectomy and fusion combined with ACDF or ACCF, is often recommended. Additionally, ACDF has been applicated as the mainstay of treatment for CSM patients whose compression is confined to the disc level and has fewer than three compression segments, but the high incidence of complication should be expected, as well as the high readmission rate and additional costs. Meanwhile, as knowledge about CSM and its surgical treatment continues to expand, many trials have demonstrated the superiority of CDR in preserving the mobility of the index segments and reducing the incidence of complications. Therefore, CDR could be a better option than ACDF for patients with similar pathological changes but relatively stable cervical spine. This article summarized the pathophysiology of CSM as well as the characteristics, indications, clinical efficacy, and safety of various surgical treatments, and pays special attention to the clinical selection of CDR and ACDF, which can provide a more comprehensive reference for spine surgeons to make clinical decisions about CSM surgery.

References

[1] Watanabe, M., et al. Japanese Orthopaedic Association (JOA) Clinical practice guidelines on the Management of Cervical Spondylotic Myelopathy, 2020 - Secondary publication. J Orthop Sci, 2022.

[2] Nouri, A., et al. Degenerative Cervical Myelopathy: Epidemiology, Genetics, and Pathogenesis. Spine (Phila Pa 1976), 2015. 40(12): p. E675-93.

[3] Lannon, M. and E. Kachur. Degenerative Cervical Myelopathy: Clinical Presentation, Assessment, and Natural History. J Clin Med, 2021. 10(16).

[4] Yarbrough, C.K., et al. The natural history and clinical presentation of cervical spondylotic myelopathy. Adv Orthop, 2012. 2012: p. 480643.

[5] Zhang, R.J., et al. Clinical features and surgical outcomes of cervical spondylotic myelopathy in patients of different ages: a retrospective study. Spinal Cord, 2018. 56(1): pp. 7-13.

[6] Watanabe, M., et al. Japanese Orthopaedic Association (JOA) Clinical practice guidelines on the Management of Cervical Spondylotic Myelopathy, 2020 - Secondary publication. J Orthop Sci, 2023. 28(1): p. 1-45.

[7] Chen, Y.C., et al. Recent advances in the management of cervical spondylotic myelopathy: bibliometric analysis and surgical perspectives. J Neurosurg Spine, 2019. 31(3): p. 299-309.

[8] McCormick, J.R., et al. Cervical Spondylotic Myelopathy: A Guide to Diagnosis and Management. J Am Board Fam Med, 2020. 33(2): p. 303-313.

[9] Callanan, G. and K.E. Radcliff, Cervical Total Disc Replacement: Long-Term Outcomes. Neurosurg Clin N Am, 2021. 32(4): p. 461-472.

[10] Wahood, W., et al. Artificial Discs in Cervical Disc Replacement: A Meta-Analysis for Comparison of Long-Term Outcomes. World Neurosurg, 2020. 134: p. 598-613.e5.

[11] White, A.A. and M.M. Panjabi. Biomechanical considerations in the surgical management of cervical spondylotic myelopathy. Spine (Phila Pa 1976), 1988. 13(7): p. 856-60.

[12] Baptiste, D.C. and M.G. Fehlings. Pathophysiology of cervical myelopathy. Spine J, 2006. 6(6 Suppl): p. 190s-197s.

[13] Raj, P.P. Intervertebral disc: anatomy-physiology-pathophysiology-treatment. Pain Pract, 2008. 8(1): p. 18-44.

[14] Feng, C., et al. Disc cell senescence in intervertebral disc degeneration: Causes and molecular pathways. Cell Cycle, 2016. 15(13): p. 1674-84.

[15] Roberts, S., et al. Matrix metalloproteinases and aggrecanase: their role in disorders of the human intervertebral disc. Spine (Phila Pa 1976), 2000. 25(23): p. 3005-13.

[16] Park, M.S., et al. Facet joint degeneration of the cervical spine: a computed tomographic analysis of 320 patients. Spine (Phila Pa 1976), 2014. 39(12): p. E713-8.

[17] Jaumard, N.V., W.C. Welch, and B.A. Winkelstein. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng, 2011. 133(7): p. 071010.

[18] Karadimas, S.K., et al. Pathophysiology and natural history of cervical spondylotic myelopathy. Spine (Phila Pa 1976), 2013. 38(22 Suppl 1): p. S21-36.

[19] Badhiwala, J.H., et al. Degenerative cervical myelopathy—update and future directions. Nat Rev Neurol, 2020. 16(2): p. 108-124.

[20] Dalbayrak, S., et al., The contribution of cervical dynamic magnetic resonance imaging to the surgical treatment of cervical spondylotic myelopathy. Turk Neurosurg, 2015. 25(1): p. 36-42.

[21] Lee, J.B., et al. Influence of dynamic neck motion on the clinical usefulness of multi-positional MRI in cervical degenerative spondylosis. Eur Spine J, 2021. 30(6): p. 1542-1550.

[22] Tykocki, T., J. du Plessis, and G. Wynne-Jones. Correlation between the severity of myelopathy and cervical morphometric parameters on dynamic magnetic resonance imaging. Acta Neurochir (Wien), 2018. 160(6): p. 1251-1258.

[23] Lee, Y., S.Y. Kim, and K. Kim. A Dynamic Magnetic Resonance Imaging Study of Changes in Severity of Cervical Spinal Stenosis in Flexion and Extension. Ann Rehabil Med, 2018. 42(4): p. 584-590.

[24] Muhle, C., et al. Classification system based on kinematic MR imaging in cervical spondylitic myelopathy. AJNR Am J Neuroradiol, 1998. 19(9): p. 1763-71.

[25] Muhle, C., et al. Dynamic changes of the spinal canal in patients with cervical spondylosis at flexion and extension using magnetic resonance imaging. Invest Radiol, 1998. 33(8): p. 444-9.

[26] Qi, Q., et al. A New Diagnostic Medium for Cervical Spondylotic Myelopathy: Dynamic Somatosensory Evoked Potentials. World Neurosurg, 2020. 133: p. e225-e232.

[27] Yu, Z., et al. Magnetic resonance imaging and dynamic X-ray's correlations with dynamic electrophysiological findings in cervical spondylotic myelopathy: a retrospective cohort study. BMC Neurol, 2020. 20(1): p. 367.

[28] Morishita, Y., et al. Dynamic somatosensory evoked potentials to determine electrophysiological effects on the spinal cord during cervical spine extension: clinical article. J Neurosurg Spine, 2013. 19(3): p. 288-92.

[29] Yu, Z., et al. Spinal Cord Parenchyma Vascular Redistribution Underlies Hemodynamic and Neurophysiological Changes at Dynamic Neck Positions in Cervical Spondylotic Myelopathy. Front Neuroanat, 2021. 15: p. 729482.

[30] Morris, S.H., et al. Validity of transcranial motor evoked potentials as early indicators of neural compromise in rat model of spinal cord compression. Spine (Phila Pa 1976), 2015. 40(8): p. E492-7.

[31] Morris, S.H., J.J. Howard, and R. El-Hawary Comparison of Motor-Evoked Potentials Versus Somatosensory-Evoked Potentials as Early Indicators of Neural Compromise in Rat Model of Spinal Cord Compression. Spine (Phila Pa 1976), 2017. 42(6): p. E326-e331.

[32] Lee, J.B., et al. Difference of Dynamic Morphometric Changes Between in Patients with Ossification of Posterior Longitudinal Ligament and Patients with Cervical Spondylosis: Assessment by Cervical Dynamic Magnetic Resonance Imaging. World Neurosurg, 2019. 123: p. e566-e573.

[33] Muhle, C., et al. Biomechanical aspects of the subarachnoid space and cervical cord in healthy individuals examined with kinematic magnetic resonance imaging. Spine (Phila Pa 1976), 1998. 23(5): p. 556-67.

[34] Stamm, S., et al. Dynamic MRI Reveals Soft-Tissue Compression Causing Progressive Myelopathy in Postlaminectomy Patients: A Report of Three Cases. JBJS Case Connect, 2013. 3(1): p. e17.

[35] Breig, A., I. Turnbull, and O. Hassler. Effects of mechanical stresses on the spinal cord in cervical spondylosis. A study on fresh cadaver material. J Neurosurg, 1966. 25(1): p. 45-56.

[36] Jha, S.C., M. Miyazaki, and H. Tsumura. Kinetic change of spinal cord compression on flexion-extension magnetic resonance imaging in cervical spine. Clin Neurol Neurosurg, 2018. 174: p. 86-91.

[37] Hattou, L., et al. Dynamic cervical myelopathy in young adults. Eur Spine J, 2014. 23(7): p. 1515-22.

[38] Yu, Z., et al. Patients with degenerative cervical myelopathy exhibit neurophysiological improvement upon extension and flexion: a retrospective cohort study with a minimum 1-year follow-up. BMC Neurol, 2022. 22(1): p. 110.

[39] Cloward, R.B. The anterior approach for removal of ruptured cervical disks. J Neurosurg, 1958. 15(6): p. 602-17.

[40] Smith, G.W. and R.A. Robinson. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am, 1958. 40-a(3): p. 607-24.

[41] D'Souza, M., et al. Graft Materials and Biologics for Spinal Interbody Fusion. Biomedicines, 2019. 7(4).

[42] Ho-Shui-Ling, A., et al. Bone regeneration strategies: Engineered scaffolds, bioactive molecules and stem cells current stage and future perspectives. Biomaterials, 2018. 180: p. 143-162.

[43] Abjornson, C., et al. ISASS Recommendations and Coverage Criteria for Bone Graft Substitutes used in Spinal Surgery. Int J Spine Surg, 2018. 12(6): p. 757-771.

[44] Lebl, D.R. and C.M. Bono. Update on the Diagnosis and Management of Cervical Spondylotic Myelopathy. J Am Acad Orthop Surg, 2015. 23(11): p. 648-60.

[45] Qi, M., et al. Comparison of clinical outcomes between cervical disc arthroplasty and anterior cervical discectomy and fusion for the treatment of single-level cervical spondylosis: a 10-year follow-up study. Spine J, 2022.

[46] Luo, C.A., et al. The surgical outcome of multilevel anterior cervical discectomy and fusion in myelopathic elderly and younger patients. Sci Rep, 2022. 12(1): p. 4495.

[47] Li, Y., et al. Comparison of Multilevel Cervical Disc Replacement and Multilevel Anterior Discectomy and Fusion: A Systematic Review of Biomechanical and Clinical Evidence. World Neurosurg, 2018. 116: p. 94-104.

[48] Chang, C.J., et al. Comparison of anterior cervical discectomy and fusion versus artificial disc replacement for cervical spondylotic myelopathy: a meta-analysis. J Neurosurg Spine, 2022: p. 1-10.

[49] Epstein, N.E. A Review of Complication Rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int, 2019. 10: p. 100.

[50] Yerneni, K., et al. Safety of Outpatient Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis. Neurosurgery, 2020. 86(1): p. 30-45.

[51] Yew, A.Y., et al. Quantitative Risk Factor Analysis of Postoperative Dysphagia after Anterior Cervical Discectomy and Fusion (ACDF) Using the Eating Assessment Tool-10 (EAT-10). Spine (Phila Pa 1976), 2019. 44(2): p. E82-e88.

[52] Liu, J., et al. Risk factors and preventative measures of early and persistent dysphagia after anterior cervical spine surgery: a systematic review. Eur Spine J, 2018. 27(6): p. 1209-1218.

[53] Alhashash, M., M. Shousha, and H. Boehm. Adjacent Segment Disease after Cervical Spine Fusion: Evaluation of a 70 Patient Long-Term Follow-Up. Spine (Phila Pa 1976), 2018. 43(9): p. 605-609.

[54] Yang, W., et al. Superiority of 2-Level Total Disk Replacement Using a Cervical Disk Prosthesis Versus Anterior Cervical Diskectomy and Fusion. Orthopedics, 2018. 41(6): p. 344-350.

[55] Guo, S., et al. Comparison of Clinical Outcomes and Sagittal Alignment After Different Levels of Anterior Cervical Discectomy and Fusion in Patients With Cervical Spondylotic Myelopathy: From One-level to Three-level. Spine (Phila Pa 1976), 2021. 46(3): p. E153-e160.

[56] Liu, Y., et al. Comparative analysis of complications of different reconstructive techniques following anterior decompression for multilevel cervical spondylotic myelopathy. Eur Spine J, 2012. 21(12): p. 2428-35.

[57] Louie, P.K., V.M. Nemani, and J.A. Leveque. Anterior Cervical Corpectomy and Fusion for Degenerative Cervical Spondylotic Myelopathy: Case Presentation With Surgical Technique Demonstration and Review of Literature. Clin Spine Surg, 2022. 35(10): p. 440-446.

[58] Wang, T., et al. Comparison of Two Anterior Reconstructive Techniques in the Treatment of 3-Level and 4 Level Cervical Spondylotic Myelopathy: A Meta-analysis of Last Decade. Geriatr Orthop Surg Rehabil, 2022. 13: p. 21514593221124415.

[59] Banno, F., et al. Anterior Cervical Corpectomy and Fusion Versus Anterior Cervical Discectomy and Fusion for Treatment of Multilevel Cervical Spondylotic Myelopathy: Insights from a National Registry. World Neurosurg, 2019. 132: p. e852-e861.

[60] Wei, F., et al. A prospective randomized cohort study on 3D-printed artificial vertebral body in single-level anterior cervical corpectomy for cervical spondylotic myelopathy. Ann Transl Med, 2020. 8(17): p. 1070.

[61] Amelot, A., M. Colman, and J.E. Loret. Vertebral body replacement using patient-specific three-dimensional-printed polymer implants in cervical spondylotic myelopathy: an encouraging preliminary report. Spine J, 2018. 18(5): p. 892-899.

[62] Reitz, H. and M.J. Joubert. Intractable Headache and Cervico-Brachialgia Treated by Complete Replacement of Cervical Intervertebral Discs with a Metal Prosthesis. S Afr Med J, 1964. 38: p. 881-4.

[63] He, J., et al. Bibliometric and visualized analysis of the top 100 most-cited articles on anterior cervical surgery. EFORT Open Rev, 2021. 6(12): p. 1203-1213.

[64] Witiw, C.D., et al. Cervical disc replacement: examining "real-world" utilization of an emerging technology. J Neurosurg Spine, 2020: p. 1-7.

[65] DiAngelo, D.J., et al. In vitro biomechanics of cervical disc arthroplasty with the ProDisc-C total disc implant. Neurosurg Focus, 2004. 17(3): p. E7.

[66] Havey, R.M., et al. Motion response of a polycrystalline diamond adaptive axis of rotation cervical total disc arthroplasty. Clin Biomech (Bristol, Avon), 2019. 62: p. 34-41.

[67] Bydon, M., et al. Cervical Total Disc Replacement: Food and Drug Administration-Approved Devices. Neurosurg Clin N Am, 2021. 32(4): p. 425-435.

[68] Zhou, F., et al. Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data. J Neurosurg Spine, 2020: p. 1-6.

[69] Nunley, P., K.F.V. Schouwen, and M. Stone. Cervical Total Disc Replacement: Indications and Technique. Neurosurg Clin N Am, 2021. 32(4): p. 419-424.

[70] Wang, X., et al. Effect of Disc Height and Degree of Distraction on Heterotopic Ossification After Cervical Disc Replacement. World Neurosurg, 2021. 145: p. e100-e107.

[71] Tu, T.H., et al. Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions. J Neurosurg Spine, 2023. 38(3): p. 372-381.

[72] Badhiwala, J.H., et al. Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up. J Spine Surg, 2020. 6(1): p. 217-232.

[73] Li, Z., et al. Efficacy and Safety of Surgical Interventions for Treating Multilevel Cervical Spondylotic Myelopathy via Anterior Approach: A Network Meta-Analysis. Pain Physician, 2019. 22(4): p. E275-e286.

[74] Pehlivanoglu, T., et al. Clinical and Radiographic Outcome of Patients With Cervical Spondylotic Myelopathy Undergoing Total Disc Replacement. Spine (Phila Pa 1976), 2019. 44(20): p. 1403-1411.

[75] Peng, Z., et al. A meta-analysis comparing the short- and mid- to long-term outcomes of artificial cervical disc replacement(ACDR) with anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. Int Orthop, 2022. 46(7): p. 1609-1625.

[76] Ghobrial, G.M., et al. Symptomatic Adjacent Level Disease Requiring Surgery: Analysis of 10-Year Results From a Prospective, Randomized, Clinical Trial Comparing Cervical Disc Arthroplasty to Anterior Cervical Fusion. Neurosurgery, 2019. 84(2): p. 347-354.

[77] Price, R.L., D. Coric, and W.Z. Ray. Cervical Total Disc Replacement: Complications and Complication Avoidance. Neurosurg Clin N Am, 2021. 32(4): p. 473-481.

[78] Shen, Y.W., et al. The Effect of Preoperative Cervical Spondylosis on Heterotopic Ossification After Cervical Disc Replacement. Global Spine J, 2022: p. 21925682221094265.

[79] Li, G., et al. Postoperative Heterotopic Ossification After Cervical Disc Replacement Is Likely a Reflection of the Degeneration Process. World Neurosurg, 2019. 125: p. e1063-e1068.

[80] Tian, Y., et al. [A long-term follow-up study on the occurrence of heterotopic ossification after artificial cervical disc replacement with Discover disc]. Zhonghua Yi Xue Za Zhi, 2020. 100(45): p. 3584-3589.

[81] Bajamal, A.H., et al. Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recom-mendations. Neurospine, 2019. 16(3): p. 421-434.

[82] Jain, A., et al. Does Segmental Kyphosis Affect Surgical Outcome after a Posterior Decompressive Laminectomy in Multiseg-mental Cervical Spondylotic Myelopathy? Asian Spine J, 2017. 11(1): p. 24-30.

[83] Ghogawala, Z., et al. Effect of Ventral vs Dorsal Spinal Surgery on Patient-Reported Physical Functioning in Patients With Cervical Spondylotic Myelopathy: A Randomized Clinical Trial. Jama, 2021. 325(10): p. 942-951.

[84] Rissanen, A., et al. Long-Term Follow-Up After Cervical Laminectomy without Fusion for Cervical Spondylotic Myelopathy. World Neurosurg, 2022. 167: p. e222-e235.

[85] Kurihara, K., et al. Effect of Minimally Invasive Selective Laminectomy for Cervical Spondylotic Myelopathy on Degenerative Spondylolisthesis. Clin Spine Surg, 2022. 35(1): p. E242-e247.

[86] Kotter, M.R.N., et al. Surgical Outcomes Following Laminectomy With Fusion Versus Laminectomy Alone in Patients With Degenerative Cervical Myelopathy. Spine (Phila Pa 1976), 2020. 45(24): p. 1696-1703.

[87] Badiee, R.K., et al. Preoperative Narcotic Use, Impaired Ambulation Status, and Increased Intraoperative Blood Loss Are Independent Risk Factors for Complications Following Posterior Cervical Laminectomy and Fusion Surgery. Neurospine, 2019. 16(3): p. 548-557.

[88] Hirabayashi, K., et al., Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine (Phila Pa 1976), 1983. 8(7): p. 693-9.

[89] Sivaraman, A., et al. Skip laminectomy and laminoplasty for cervical spondylotic myelopathy: a prospective study of clinical and radiologic outcomes. J Spinal Disord Tech, 2010. 23(2): p. 96-100.

[90] Wang, D.L., et al. The Anatomical and Biomechanical Superiority of Novel Posterior En Bloc Elevation Cervical Laminoplasty. Surg Innov, 2021. 28(5): p. 552-559.

[91] Chen, C., et al. Clinical and Radiographic Outcomes of Modified Unilateral Open-door Laminoplasty with Posterior Muscle-Ligament Complex Preservation for Cervical Spondylotic Myelopathy. Spine (Phila Pa 1976), 2019. 44(24): p. 1697-1704.

[92] Ghasemi, A.A. and B. Behfar. Outcome of laminoplasty in cervical spinal cord injury with stable spine. Asian J Neurosurg, 2016. 11(3): p. 282-6.

[93] Cho, S.K., et al. Cervical Laminoplasty: Indications, Surgical Considerations, and Clinical Outcomes. J Am Acad Orthop Surg, 2018. 26(7): p. e142-e152.

[94] Braly, B.A., et al. Operative treatment of cervical myelopathy: cervical laminoplasty. Adv Orthop, 2012. 2012: p. 508534.

[95] Wang, J., et al. Laminoplasty versus laminectomy with fusion for treatment of multilevel cervical compressive myelopathy: an updated meta-analysis. Postgrad Med J, 2022. 98(1163): p. 680-688.

[96] Sayana, M.K., H. Jamil, and A. Poynton. Cervical laminoplasty for multilevel cervical myelopathy. Adv Orthop, 2011. 2011: p. 241729.

[97] Yuan, X., et al. Comparison of laminectomy and fusion vs laminoplasty in the treatment of multilevel cervical spondylotic myelopathy: A meta-analysis. Medicine (Baltimore), 2019. 98(13): p. e14971.

[98] Singhatanadgige, W., et al. Outcomes following Laminoplasty or Laminectomy and Fusion in Patients with Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament: A Systematic Review. Global Spine J, 2016. 6(7): p. 702-709.

[99] Chen, H., et al. Short-Term Outcomes of Anterior Fusion-Nonfusion Hybrid Surgery versus Posterior Cervical Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy. World Neurosurg, 2018. 116: p. e1007-e1014.

[100] Zhang, J., et al. Comparative Study Between Anterior Cervical Discectomy and Fusion with ROI-C Cage and Laminoplasty for Multilevel Cervical Spondylotic Myelopathy without Spinal Stenosis. World Neurosurg, 2019. 121: p. e917-e924.

[101] Lee, J.J., et al. Clinical and radiological outcomes of multilevel cervical laminoplasty versus three-level anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy. Quant Imaging Med Surg, 2020. 10(11): p. 2112-2124.

[102] Lopez, W.Y., et al. Laminoplasty-an underutilized procedure for cervical spondylotic myelopathy. Spine J, 2021. 21(4): p. 571-577.

[103] McAfee, P.C., et al. One-stage anterior cervical decompression and posterior stabilization. A study of one hundred patients with a minimum of two years of follow-up. J Bone Joint Surg Am, 1995. 77(12): p. 1791-800.

[104] König, S.A. and U. Spetzger. Surgical management of cervical spondylotic myelopathy - indications for anterior, posterior or combined procedures for decompression and stabilisation. Acta Neurochir (Wien), 2014. 156(2): p. 253-8; discussion 258.

[105] Zaveri, G.R. and N.P. Jaiswal. A Comparison of Clinical and Functional Outcomes Following Anterior, Posterior, and Combined Approaches for the Management of Cervical Spondylotic Myelopathy. Indian J Orthop, 2019. 53(4): p. 493-501.

[106] Schultz, K.D., Jr., et al. Single-stage anterior-posterior decompression and stabilization for complex cervical spine disorders. J Neurosurg, 2000. 93(2 Suppl): p. 214-21.

[107] Sun H L, et al. Characteristics and preventive measures of cervical spondylosis in young desk workers. Electronic journal of clinical medicine literature, 2017. 4(15): p. 2812-2813.

[108] Lv, B., et al. Analysis of Correlation Between Age and Cervical Facet Joint Degeneration and Modic Changes in Patients with Cervical Spondylotic Myelopathy. Med Sci Monit, 2019. 25: p. 7882-7888.

[109] Radcliff, K., J. Zigler, and J. Zigler. Costs of cervical disc replacement versus anterior cervical discectomy and fusion for treatment of single-level cervical disc disease: an analysis of the Blue Health Intelligence database for acute and long-term costs and complications. Spine (Phila Pa 1976), 2015. 40(8): p. 521-9.

[110] Ding, C., et al. Comparison of cervical disc arthroplasty with anterior cervical discectomy and fusion for the treatment of cervical spondylotic myelopathy. Acta Orthop Belg, 2013. 79(3): p. 338-46.

[111] Aprato, A., et al. Heterotopic ossification in primary total hip arthroplasty: risk factor analysis. Eur J Orthop Surg Traumatol, 2023. 33(4): p. 1037-1041.

[112] Hui, N., et al. Cervical Total Disc Replacement and Heterotopic Ossification: A Review of Literature Outcomes and Biomechanics. Asian Spine J, 2021. 15(1): p. 127-137.

[113] Łęgosz, P., et al. Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment. Biomed Res Int, 2019. 2019: p. 3860142.

[114] Jin, Y.J., et al. An analysis of heterotopic ossification in cervical disc arthroplasty: a novel morphologic classification of an ossified mass. Spine J, 2013. 13(4): p. 408-20.

[115] Kim, K.S. and D.H. Heo. Do Postoperative Biomechanical Changes Induce Heterotopic Ossification After Cervical Arthroplasty? A 5-Year Follow-up Study. Clin Spine Surg, 2016. 29(6): p. E309-13.

[116] Cho, Y.H., K.S. Kim, and Y.M. Kwon. Heterotopic Ossification after Cervical Arthroplasty with ProDisc-C: Time Course Radiographic Follow-up over 3 years. Korean J Spine, 2013. 10(1): p. 19-24.

[117] Ganbat, D., et al. Effect of mechanical loading on heterotopic ossification in cervical total disc replacement: a three-dimensional finite element analysis. Biomech Model Mechanobiol, 2016. 15(5): p. 1191-9.

[118] Yang W X, et al. Effect of Bushen Shuji Granule on factors related to heterotopic ossification in ankylosing spondylitis. Chinese Journal of Traditional Chinese Medicine, 2019. 34(09): p. 4405-4409.

How to cite this paper

Surgical Treatment of Cervical Spondylotic Myelopathy

How to cite this paper: Senyuan Chen, Ziqiao Zhang, Runfu Chen, Rongping Zhou. (2023) Surgical Treatment of Cervical Spondylotic Myelopathy. International Journal of Clinical and Experimental Medicine Research7(3), 437-451.

DOI: https://dx.doi.org/10.26855/ijcemr.2023.07.026