Cervical surgical techniques for the treatment of cervical spondylotic myelopathy

Praveen V. Mummaneni, Michael G. Kaiser, Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Timothy C. Ryken, Tanvir F. Choudhri, Edward Vresilovic, Daniel K. Resnick

Research output: Contribution to journalReview article

98 Citations (Scopus)

Abstract

Object. The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions. Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.

Original languageEnglish (US)
Pages (from-to)130-141
Number of pages12
JournalJournal of Neurosurgery: Spine
Volume11
Issue number2
DOIs
StatePublished - Aug 1 2009

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Laminectomy
Spinal Cord Diseases
Diskectomy
Guidelines
Spine
Therapeutics
Medical Subject Headings
National Library of Medicine (U.S.)
Peer Review
Arthrodesis
Evidence-Based Medicine
Decompression
Joints
Databases
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Mummaneni, P. V., Kaiser, M. G., Matz, P. G., Anderson, P. A., Groff, M. W., Heary, R. F., ... Resnick, D. K. (2009). Cervical surgical techniques for the treatment of cervical spondylotic myelopathy. Journal of Neurosurgery: Spine, 11(2), 130-141. https://doi.org/10.3171/2009.3.SPINE08728
Mummaneni, Praveen V. ; Kaiser, Michael G. ; Matz, Paul G. ; Anderson, Paul A. ; Groff, Michael W. ; Heary, Robert F. ; Holly, Langston T. ; Ryken, Timothy C. ; Choudhri, Tanvir F. ; Vresilovic, Edward ; Resnick, Daniel K. / Cervical surgical techniques for the treatment of cervical spondylotic myelopathy. In: Journal of Neurosurgery: Spine. 2009 ; Vol. 11, No. 2. pp. 130-141.
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abstract = "Object. The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions. Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.",
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Mummaneni, PV, Kaiser, MG, Matz, PG, Anderson, PA, Groff, MW, Heary, RF, Holly, LT, Ryken, TC, Choudhri, TF, Vresilovic, E & Resnick, DK 2009, 'Cervical surgical techniques for the treatment of cervical spondylotic myelopathy', Journal of Neurosurgery: Spine, vol. 11, no. 2, pp. 130-141. https://doi.org/10.3171/2009.3.SPINE08728

Cervical surgical techniques for the treatment of cervical spondylotic myelopathy. / Mummaneni, Praveen V.; Kaiser, Michael G.; Matz, Paul G.; Anderson, Paul A.; Groff, Michael W.; Heary, Robert F.; Holly, Langston T.; Ryken, Timothy C.; Choudhri, Tanvir F.; Vresilovic, Edward; Resnick, Daniel K.

In: Journal of Neurosurgery: Spine, Vol. 11, No. 2, 01.08.2009, p. 130-141.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Cervical surgical techniques for the treatment of cervical spondylotic myelopathy

AU - Mummaneni, Praveen V.

AU - Kaiser, Michael G.

AU - Matz, Paul G.

AU - Anderson, Paul A.

AU - Groff, Michael W.

AU - Heary, Robert F.

AU - Holly, Langston T.

AU - Ryken, Timothy C.

AU - Choudhri, Tanvir F.

AU - Vresilovic, Edward

AU - Resnick, Daniel K.

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Object. The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions. Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.

AB - Object. The objective of this systematic review was to use evidence-based medicine to compare the efficacy of different surgical techniques for the treatment of cervical spondylotic myelopathy (CSM). Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to anterior and posterior cervical spine surgery and CSM. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. A variety of techniques have improved functional outcome after surgical treatment for CSM, including anterior cervical discectomy with fusion (ACDF), anterior cervical corpectomy with fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion (Class III). Anterior cervical discectomy with fusion and ACCF appear to yield similar results in multilevel spine decompression for lesions at the disc level. The use of anterior plating allows for equivalent fusion rates between these techniques (Class III). If anterior fixation is not used, ACCF may provide a higher fusion rate than multilevel ACDF but also a higher graft failure rate than multilevel ACDF (Class III). Anterior cervical discectomy with fusion, ACCF, laminectomy, laminoplasty, and laminectomy with arthrodesis all provide near-term functional improvement for CSM. However, laminectomy is associated with late deterioration compared with the other types of anterior and posterior surgeries (Class III). Conclusions. Multiple approaches exist with similar near-term improvements; however, laminectomy appears to have a late deterioration rate that may need to be considered when appropriate.

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Mummaneni PV, Kaiser MG, Matz PG, Anderson PA, Groff MW, Heary RF et al. Cervical surgical techniques for the treatment of cervical spondylotic myelopathy. Journal of Neurosurgery: Spine. 2009 Aug 1;11(2):130-141. https://doi.org/10.3171/2009.3.SPINE08728