Cervical osteotomies for neurological deformities

Area of Science:

• Orthopedic Surgery
• Neurosurgery
• Spinal Deformity Correction

Background:

• Cervical deformity (CD) with myelopathy presents significant challenges in spinal alignment.
• Surgical correction is crucial for preventing myelopathy progression and spinal cord injury.

Purpose of the Study:

• To detail the experience and techniques for cervical osteotomies in patients with cervical deformity and myelopathy.
• To evaluate the efficacy of different osteotomy approaches in correcting cervical alignment.

Main Methods:

• Retrospective review of 35 patients undergoing cervical osteotomy for CD and myelopathy (2000-2010).
• Data collection included demographics, surgical approach (anterior vs. pedicle subtraction osteotomy - PSO), and radiographic parameters (cervical lordosis, basion plumb line).
• Pre- and post-operative Neck Disability Index (NDI) scores were assessed.

Main Results:

• 35 patients with CD and myelopathy underwent cervical osteotomy with an average follow-up of 3.4 years.
• Anterior osteotomy (31 patients) achieved mean angular correction of 27.7° and translational correction of 1.8 cm.
• Pedicle subtraction osteotomy (4 patients) achieved mean angular correction of 48.8° and translational correction of 2.8 cm.
• Both methods resulted in similar improvements in pre- and post-operative NDI scores.

Conclusions:

• Cervical osteotomies are effective in correcting cervical deformity and associated myelopathy.
• Spinal re-alignment is critical for mitigating myelopathy progression and protecting the spinal cord.
• Both anterior and PSO techniques demonstrate comparable functional improvements in patients with CD and myelopathy.