Microscopic anterior cervical oblique corpectomy for management of cervical spondylotic myelopathy / Mohamed Ali Abdelkareem ; Supervised Khaled Anbar , Omar Yusuf , Mohamed Adel

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Objective: This study details assessment of the indications, safety, efficacy and complications of an anterolateral approach( Microscopic anterior cervical oblique corpectomy) for treatment of cervical spondylotic myelopathy alone or associated with radiculopathy. Methods: A retrospective study conducted on thirty patients with cervical spondylotic myelopathy or myelo-radiculopathy confirmed by clinical and radiological data, refractory to non-surgical measures for at least 6 months. Patients with anterior cervical compression associated with either straightening or kyphosis of cervical spine in the absence of instability is the general indication. All patients were operated upon at Cairo university hospitals. Outcome of patients was categorized according to the modified Japanese Orthopedic Association (mJOA) Scale and the recovery rate was calculated. Results: Average age of presentation was 55.33 years, male to female ratio was 3:2 and average duration of symptoms was 14.9 months. The most common presenting symptom was progressive myelopathy; five patients were myelopathy associated with radiculopathy . Most common operated level was C5-6 (41.17%). Excellent and good outcomes of patients with myelopathy were obtained in 75% of the patients and the mean recovery rate was 74.4%. The follow up after 6 months with no recurrence, instability, progressive kyphosis, vertebral collapse nor other late complications as adjacent segment disease. Conclusion: MOC is an effective procedure that allow anterior decompression of spinal cord safely with no instrumentation and with satisfactory postoperative outcome, In the same time it preserves stability of cervical spine ,also saving the integrity of surrounding neurovascular structures

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