MANAGEMENT OF CERVICAL SPONDYLOTIC MYELOPATHY BY CENTRAL CORPECTOMY, STRUT GRAFT ARTHRODESIS AND PLATE

Abstract

Cervical spondylotic myelopathy (CSM) is defined as spinal cord dysfunction secondary to extrinsic compression of the cord or its vascular supply, or both, that is caused by degenerative disease of the cervical spine. It is the most common type of spinal cord dysfunction in patients who are older than 55 years of age. It is associated with congenital or developmental stenosis of the cervical canal. The problem begins with degenerative changes in the disk, which produce secondary changes in the adjacent osseous and soft-tissue structures. Encroachment on the available space in the spinal canal results from osteophytic spurring of the facet and uncovertebral joints, compression of the spinal cord results, this leads to pathological changes in corticospinal tract and later destruction of anterior horn cells, demyelination of lateral and dorsolateral tracts. Free radical - and cation - mediated cell injury, glutamatergic toxicity and apoptosis have relevance to the pathophysiology of CSM. Summary of Cases:_ Since 1998-1999, 30 patients diagnosed as having CSM had been surgically treated. By prospective plane, the only surgical treatment offered was that of central corpectomy, strut grafting and plate. They were 26 males and 4 females, the age ranged from 36- 70 years old with the median age 53 years old.