Türk Nöroşirürji Dergisi 2022 , Vol 32 , Num 3
Anterior Surgical Techniques in Cervical Spondylotic Myelopathies
Orkun KOBAN1,Ferhat HARMAN2
1Lokman Hekim Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye
2Marmara Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye
3Marmara Üniversitesi, Nörolojik Bilimler Enstitüsü, Beyin ve Sinir Cerrahi Anabilim Dalı, İstanbul, Türkiye
Cervical spondylotic myelopathy is the most common degenerative spine problem in patients over 55 years of age. In case of progressive narrowing of the spinal canal, myelomalacia may develop as a result of ischemic events in addition to the direct compressive effect on the spinal cord. Although progress has been made in the early diagnosis and treatment of these cases, discussions about the optimal approach in the surgical treatment continue. Anterior cervical discectomy has a limited number of indications due to the restrictions in the decompression limits at the corpus level. In addition, the possibility of developing complications has been found to be higher with multi-level corpectomy. More than two levels of corpectomy may increase fusion and instrumentation failures. In order to prevent this, the skip corpectomy technique has been suggested. Skip corpectomy allows the use of shorter grafts and instrumentation as some corpi are preserved with skipping, aiming to reduce the stripping forces. Oblique corpectomy has the advantage of not using instrumentation, but loss of surgical orientation can occur. In this article, the surgical treatments applied with the anterior approach in patients with cervical spondylotic myelopathy are discussed. Anahtar Kelimeler : Anterior approach, Corpectomy, Cervical spondylotic myelopathy, Cervical discectomy, Cervical spinal stenosis