[Spontaneous ossification of the cervical spine after subtotal surgery spondylotic myelopathy]

Subtotal corporectomy without fusion (SCWF) is a misunderstood surgical procedure used in the treatment of spondylotic myelopathy. This clinical study was performed to evaluate the efficiency of the SCWF. Long term neurological status and cervical spine ossification were specially studied. Sixty-four patients, operated between 1990 and 2003, were evaluated. The average follow-up period was five years. To assess the severity of neurological symptoms, a functional seven-point classification scale was used. Discriminant analysis was applied as statistic. There was a significant correlation between outcome, functional preoperative score, age, duration of the compression and intramedullary lesion in NMR. After SCWF, no secondary cervical instability was observed. Conversely, we show, for the first time in the literature, that on the twenty-one patients who were the subject of late 3D CT scan, there exists a true rebuilding of the cervical bone with spontaneous fusion and respect of cervical cord decompression. We conclude that the SCWF is a safe and efficient treatment for cervical spondylotic myelopathy. No fusion is required regardless of the number of levels, providing there is no preoperative instability. This surgical procedure which does not require any cervical immobilization considerably decreases surgical risks and costs imposed by the society.