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Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion

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Abstract

Purpose

To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy (OCC) for cervical compressive myelopathy.

Methods

This retrospective study included 109 patients—93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental movements were assessed on neutral and dynamic cervical radiographs. Neurological function was measured by Nurick’s grade and modified Japanese Orthopedic Association (JOA) scores. Eighty-eight patients (81%) underwent either a single- or two-level corpectomy; the remaining (19%) undergoing three- or four-level corpectomies. The average duration of follow-up was 30.52 months.

Results

The Nurick’s grade and the JOA scores showed statistically significant improvements after surgery (p < 0.001). The mean postoperative segmental angle in the neutral position straightened by 4.7 ± 6.5°. The residual segmental range of movement for a single-level corpectomy was 16.7° (59.7% of the preoperative value), for two-level corpectomy it was 20.0° (67.2%) and for three-level corpectomies it was 22.9° (74.3%). 63% of patients with lordotic spines continued to have lordosis postoperatively while only one became kyphotic without clinical worsening. Four patients with preoperative kyphotic spines showed no change in spine curvature. None developed spinal instability.

Conclusions

The OCC preserves segmental motion in the short-term, however, the tendency towards straightening of the spine, albeit without clinical worsening, warrants serial follow-up imaging to determine whether this motion preservation is long lasting.

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Authors and Affiliations

  1. Section of Neurosurgery, Department of Neurological Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India

    Ari George Chacko, Mathew Joseph, Mazda Keki Turel & Krishna Prabhu

  2. Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne, Switzerland

    Roy Thomas Daniel

  3. Department of Psychiatry, Christian Medical College, Vellore, 632004, India

    K. S. Jacob

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  1. Ari George Chacko
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  2. Mathew Joseph
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  3. Mazda Keki Turel
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Correspondence to Ari George Chacko.

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Chacko, A.G., Joseph, M., Turel, M.K. et al. Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion. Eur Spine J 21, 1360–1367 (2012). https://doi.org/10.1007/s00586-011-2137-3

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  • DOI: https://doi.org/10.1007/s00586-011-2137-3

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