ANTERIOR APPROACH PROCEDURES VERSUS POSTERIOR APPROACHES AS A SURGICAL CHOICE IN MANAGEMENT OF CERVICAL SPONDYLOTIC MYELOPATHY

Abstract

In this systematic review designed to seek a gold standard technique regarding the surgical approaches to the cervical spine in the setting of cervical spondylotic myelopathy; we began with a thorough review of spine surgery literature across different disciplines covering anatomy, physiology, and histopathology of the cervical spine as well as different modalities in management of cervical spodylotic myelopathy.

Apart from the relative paucity of well-conducted studies addressing the subject, we managed to retrieve over 20 comparative studies to enroll in our review. Of those 20 studies only five satisfied our inclusion and exclusion criteria.

By careful analysis of the included studies taking into consideration the pre- and postoperative clinical data, complications rate, as well as approach specific variables like operative time and blood loss; we concluded that a single gold standard surgical approach for managing cervical spondylotic myelopathy can’t be found. We recommend an individualized method for every patient based on understanding of his/her pathoanatomy and clinical picture.