European Spine Journal

, Volume 22, Issue 1, pp 128–134

Long-term follow-up results of the Cloward procedure for cervical spondylotic myelopathy

  • Olimpio Galasso
  • Massimo Mariconda
  • Bruno Iannò
  • Marco De Gori
  • Giorgio Gasparini
Original Article

DOI: 10.1007/s00586-012-2457-y

Cite this article as:
Galasso, O., Mariconda, M., Iannò, B. et al. Eur Spine J (2013) 22: 128. doi:10.1007/s00586-012-2457-y

Abstract

Purpose

To assess the long-term results of anterior cervical discectomy and fusion using the Cloward procedure for the treatment of cervical spondylotic myelopathy, and to identify possible clinical outcome predictors.

Methods

A total of 14 cases with a 10-year postoperative follow-up were available (82.4 % of the surviving patients). Patients underwent preoperative and postoperative neurological examination. The symptom severity was graded according to the Nurick scale. MRI measurements were obtained preoperatively. Cervical spine radiographs were obtained preoperatively and at the time of follow-up.

Results

The mean improvement of the clinical status of patients on the Nurick scale was 1.43 ± 0.51 (range 1–2) with respect to the baseline values (p < 0.001), with a 62.5 % recovery rate. A positive association between the improvement of the Nurick scale and the length of follow-up was detected with an age-adjusted univariate analysis (p = 0.042). The Nurick grade improvement was also directly related to preoperative lower limb hyperreflexia (p = 0.039), spasticity (p = 0.017), and bladder dysfunction (p = 0.048). At the time of follow-up, an adjacent discopathy was noted above and below the operated level(s) in eight and six patients, respectively.

Conclusions

The Cloward technique is a safe and effective procedure for the treatment of cervical spondylotic myelopathy. The patients’ preoperative neurological status and the length of follow-up affect the grade of postoperative ambulatory improvement.

Keywords

Cervical spondylotic myelopathyAnterior cervical discectomy and fusionClowardLong-term follow-up

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Olimpio Galasso
    • 1
  • Massimo Mariconda
    • 2
  • Bruno Iannò
    • 1
  • Marco De Gori
    • 1
  • Giorgio Gasparini
    • 1
  1. 1.Department of Orthopaedic and Trauma Surgery, School of MedicineUniversity “Magna Græcia” of CatanzaroCatanzaroItaly
  2. 2.Department of Orthopaedic and Trauma SurgeryUniversity “Federico II” of NaplesNaplesItaly