Our Summary

This research paper describes a new surgical technique for treating a condition known as cervical spondylotic myelopathy, which is caused by degenerative changes in the neck portion of the spine. The common treatment for this condition when it affects three or more levels of the spine is a procedure known as multilevel laminectomy, which involves removing part of the vertebrae to relieve pressure on the spinal cord. However, this procedure can sometimes lead to instability in the spine and a condition known as kyphosis, where the spine curves abnormally outward.

The researchers propose a different approach to this surgery, specifically for the C7 vertebra which is located at the junction between the neck and the chest. Instead of removing the entire vertebra, they suggest making a cut at an obtuse angle, leaving parts of the vertebra attached to the surrounding ligaments and muscles. They believe that this method reduces the risk of spinal instability while still relieving pressure on the spinal cord.

FAQs

  1. What is cervical spondylotic myelopathy and how is it typically treated?
  2. What are the potential complications of the common treatment for cervical spondylotic myelopathy?
  3. Can you explain the new surgical technique proposed by the researchers for treating this condition?

Doctor’s Tip

A doctor might tell a patient that spinal decompression can help relieve pressure on the spinal cord and nerves, reducing pain and improving overall function. It is important for patients to follow post-operative instructions carefully, including maintaining proper posture, engaging in physical therapy, and avoiding activities that put strain on the spine. Additionally, patients should continue to follow up with their doctor regularly to monitor their progress and address any concerns.

Suitable For

Patients who are typically recommended spinal decompression include those with:

  1. Herniated or bulging discs: Spinal decompression can help relieve pressure on the nerves caused by herniated or bulging discs in the spine.

  2. Degenerative disc disease: Spinal decompression can help alleviate pain and improve mobility in patients with degenerative disc disease.

  3. Sciatica: Spinal decompression can help relieve pain and numbness caused by compression of the sciatic nerve.

  4. Spinal stenosis: Spinal decompression can help widen the spinal canal and reduce pressure on the spinal cord and nerves in patients with spinal stenosis.

  5. Facet joint syndrome: Spinal decompression can help reduce pain and improve function in patients with facet joint syndrome.

  6. Failed back surgery syndrome: Spinal decompression may be recommended for patients who have not experienced relief from previous back surgeries.

  7. Chronic back pain: Spinal decompression may be considered as a treatment option for patients with chronic back pain that has not responded to conservative treatments.

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are a suitable candidate for spinal decompression therapy.

Timeline

Before spinal decompression:

  • Patient experiences symptoms of cervical spondylotic myelopathy, such as neck pain, stiffness, weakness in the arms and legs, and difficulty walking.
  • Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis.
  • Patient discusses treatment options with their healthcare provider, including the possibility of spinal decompression surgery.
  • Patient prepares for surgery by following pre-operative instructions, such as fasting before the procedure.

After spinal decompression:

  • Patient undergoes the spinal decompression surgery, which involves making a cut at an obtuse angle in the C7 vertebra to relieve pressure on the spinal cord.
  • Patient is monitored closely in the recovery room before being moved to a hospital room for further observation.
  • Patient may experience some pain and discomfort following the surgery, which is managed with pain medication.
  • Patient begins physical therapy to help regain strength and mobility in the neck and spine.
  • Patient follows post-operative instructions, such as avoiding heavy lifting and gradually increasing activity levels.
  • Patient attends follow-up appointments with their healthcare provider to monitor their progress and address any concerns.

What to Ask Your Doctor

  1. Can spinal decompression surgery be an option for my condition, and how does it compare to other surgical techniques such as multilevel laminectomy?

  2. What are the potential risks and complications associated with spinal decompression surgery, particularly at the C7 vertebra level?

  3. What is the expected recovery time and rehabilitation process after undergoing spinal decompression surgery?

  4. Will I need to undergo physical therapy or other forms of rehabilitation after the surgery to regain strength and mobility in my neck and spine?

  5. How long will the effects of spinal decompression surgery last, and are there any long-term implications or considerations I should be aware of?

  6. Are there any alternative treatments or non-surgical options available for my condition, and how do they compare to spinal decompression surgery in terms of effectiveness and long-term outcomes?

  7. What is the success rate of spinal decompression surgery for treating cervical spondylotic myelopathy, and what factors may affect the success of the procedure in my specific case?

  8. Will I need to make any lifestyle or activity modifications after the surgery to prevent further degeneration or complications in my neck and spine?

  9. How often will I need to follow up with you or a specialist after the surgery to monitor my recovery and ensure that the procedure was successful?

  10. Are there any specific precautions or warning signs I should be aware of after the surgery that may indicate a need for immediate medical attention or intervention?

Reference

Authors: Jhas S, Pirouzmand F. Journal: Clin Spine Surg. 2016 Mar;29(2):49-51. doi: 10.1097/BSD.0000000000000345. PMID: 26889986