272758

Anterior Approach for Multilevel Cervical Disc Prolapse with Spondylotic Myelopathy: Surgical Results, Prognostic Factors and Efficacy of Intraoperative Neuromonitoring

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Last updated: 01 Jan 2025

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Abstract

Abstract 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 suc-cessful 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.

DOI

10.21608/mjcu.2022.272758

Keywords

Cervical disc, Myelopathy, fusion, Neuro-monitoring

Authors

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MOHAMED ELHAWARY, M.D.;

Last Name

RAMY TEAMA, M.D.

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First Name

HANY

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EL NEMR, M.D.

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Affiliation

The Department of Neurosurgery, Faculty of Medicine, Benha University

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Volume

90

Article Issue

9

Related Issue

37084

Issue Date

2022-09-01

Receive Date

2022-12-05

Publish Date

2022-09-01

Page Start

1,867

Page End

1,873

Print ISSN

0045-3803

Online ISSN

2536-9806

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https://mjcu.journals.ekb.eg/article_272758.html

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https://mjcu.journals.ekb.eg/service?article_code=272758

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272,758

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Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

MainTitle

Anterior Approach for Multilevel Cervical Disc Prolapse with Spondylotic Myelopathy: Surgical Results, Prognostic Factors and Efficacy of Intraoperative Neuromonitoring

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Article

Created At

22 Jan 2023