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In the nonsurgical treatments of degenerative cervical myelopathy, cervical spine manipulation therapy and cervical traction are at higher risk of causing neurologic complications.
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Surgical treatments of degenerative cervical diseases can injure spinal cord, spinal nerves, cranial nerves, and sympathetic nerve trunk and major vessels and lead to developing neurologic complications.
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Anterior cervical corpectomy and posterior fixation surgery are at higher risk of inducing severe complications than
Neurologic Complications in Managing Degenerative Cervical Myelopathy: Pathogenesis, Prevention, and Management
Section snippets
Key points
Neurologic complications of nonsurgical management
Nonsurgical treatment of degenerative cervical diseases includes cervical immobilization with a soft collar, the use of anti-inflammatory and/or muscle relaxants, spinal injections, manipulation therapy, thermal therapy, cervical traction, discouragement of high-risk activities, and an avoidance of risky environment.6, 7, 8 Among these treatments, manipulation therapy is known to cause deterioration of myelopathy and ischemic neurologic complications.9, 10 Although it is less often than
Neurologic complications of surgical management for degenerative cervical myelopathy patients
A variety of techniques have been developed to improve functional outcomes of DCM, including anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), laminoplasty, laminectomy, and laminectomy with fusion.17 Regarding the complications of surgical treatments to cause neurologic symptoms, the spinal cord, spinal nerves, and vertebral artery can be injured by both anterior and posterior approaches, and cranial nerves, sympathetic nerve trunk, and carotid
Summary
There are a variety of neurologic complications with the nonsurgical and surgical treatments for DCM. Ten common or disabling complications are selected, and the incidence, pathogenesis, prevention, and management are reviewed. Among the nonsurgical treatments for DSM, cervical spine manipulation therapy and cervical traction are at higher risk of causing neurologic complications. Surgical treatments for degenerative cervical diseases can injure spinal cord, spinal nerves, cranial nerves,
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2021, NeurochirurgieAnterior decompression and plate fixation in treatment of cervical myelopathy: A multicentric retrospective review
2018, Acta Orthopaedica et Traumatologica TurcicaCitation Excerpt :Complications of titanium mesh and expanding cages with autograft and anterior plates may include subsidence and kyphotic deformity22,23; when using these devices, any over distraction maneuvers should be avoided. Many factors have been shown to affect results of ventral cervical decompression surgery for cervical myelopathy including age, preoperative neurological condition, chronicity and the number of stenotic spinal segments.24,25 As regard the relationship between the duration of symptoms, signs and the clinical outcome, patients with a short time before surgery (up to one year) had much better chance of improvement than those patients with more than one-year of time before surgery.
Surgical Treatment of Cervical Spondylotic Myelopathy
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Disclosure: There are no conflicts of interest and funding sources.