Selective posterior decompression of the cervical spine.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Posterior decompression for cervical canal disease can lead to axial pain and C5/C6 palsy.
• Minimizing these complications is crucial for improving patient quality of life.

Purpose of the Study:

• To evaluate the efficacy and safety of selective posterior decompression using a spinous process-splitting approach.
• To assess the prevention of postoperative axial pain and C5/C6 palsy.

Main Methods:

• A cohort of 17 patients with cervical myelopathy underwent selective posterior decompression via a transspinous approach.
• Clinical outcomes, including axial pain, C5/C6 palsy, and Japanese Orthopaedic Association scores, were compared pre- and post-operatively.
• Cervical spine range of motion and C5 level spinal cord shift were analyzed.

Main Results:

• All patients showed symptom improvement with no deterioration or reoperations.
• The Japanese Orthopaedic Association score improved significantly (10.9 to 14.4).
• No patients reported C5/C6 palsy or significant axial pain; spinal cord shift at C5 was minimal (1.7 mm).

Conclusions:

• Selective posterior decompression via the transspinous approach is a less invasive and effective treatment for cervical canal disease.
• This technique appears to reduce the incidence of postoperative axial pain and C5/C6 palsy.
• Minimal spinal cord shift may be a key factor in preventing these complications.