Median corpectomy in cervical spondylotic multisegmental stenosis

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neurology

Background:

• Cervical spondylotic myelopathy (CSM) with multisegmental stenosis poses treatment challenges.
• Laminoplasty and laminectomy are traditional but may have limitations.
• Median corpectomy is proposed as an alternative surgical approach.

Purpose of the Study:

• To evaluate the efficacy and safety of cervical median corpectomy for CSM.
• To assess neurological outcomes and complication rates associated with the procedure.

Main Methods:

• Seventeen patients with cervical myelopathy and multisegmental spondylotic stenosis underwent median corpectomy.
• Procedures included single, one-and-a-half, or dual-level corpectomy with bone grafting and anterior plate stabilization.
• Neurological status was graded using Nurick's scale, with follow-up for a mean of 13.5 months.

Main Results:

• Significant neurological improvement was observed, with notable recovery in motor function, spasticity, and sensory deficits.
• 12% improved by two grades and 38% by one grade on Nurick's scale; no patients worsened.
• Complications included one mortality from mediastinitis, screw loosening, graft displacement, and pelvic fractures.

Conclusions:

• Cervical median corpectomy is an effective surgical option for selected patients with cervical myelopathy and multisegmental stenosis.
• The procedure demonstrates positive neurological outcomes, particularly for motor function and spasticity.
• Careful patient selection and surgical technique are crucial to mitigate treatment-related complications.