0
Current Concepts Review   |    
Operative Treatment of Cervical Spondylotic Myelopathy
Raj D. Rao, MD1; Krishnaj Gourab, MD1; Kenny S. David, MD1
1 Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI 53226
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Jul 01;88(7):1619-1640. doi: 10.2106/JBJS.F.00014
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

Nonoperative treatment with collar immobilization and modification of activities improves functional status in selected patients with mild cervical spondylotic myelopathy. Careful monitoring of these patients is necessary as neurological deterioration can occur in spite of this treatment. Early operative management is beneficial for most patients with moderate or severe myelopathy. The primary aims of operative intervention for the treatment of cervical spondylotic myelopathy are decompression of the spinal cord and stabilization of levels at which excessive motion may be contributing to the myelopathy. Anterior operative approaches are preferred in patients with compression of the spinal cord at one, two, or three disc levels and those with loss of cervical lordosis. A higher rate of approach and graft-related complications generally favor a posterior approach when more than three levels are involved. Appropriate operative management results in satisfactory recovery from myelopathy in most cases, with improvement more likely in patients who have operative treatment earlier in the course of the disease and in those with less comorbidity.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    05/03/2012
    California - UCLA/OH Department of Orthopaedic Surgery
    01/22/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    12/31/2013
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    11/15/2013
    Louisiana - Ochsner Health System