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European Spine Journal

, Volume 21, Issue 7, pp 1360–1367 | Cite as

Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion

  • Ari George Chacko
  • Mathew Joseph
  • Mazda Keki Turel
  • Krishna Prabhu
  • Roy Thomas Daniel
  • K. S. Jacob
Original Article

Abstract

Purpose

To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy (OCC) for cervical compressive myelopathy.

Methods

This retrospective study included 109 patients—93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental movements were assessed on neutral and dynamic cervical radiographs. Neurological function was measured by Nurick’s grade and modified Japanese Orthopedic Association (JOA) scores. Eighty-eight patients (81%) underwent either a single- or two-level corpectomy; the remaining (19%) undergoing three- or four-level corpectomies. The average duration of follow-up was 30.52 months.

Results

The Nurick’s grade and the JOA scores showed statistically significant improvements after surgery (p < 0.001). The mean postoperative segmental angle in the neutral position straightened by 4.7 ± 6.5°. The residual segmental range of movement for a single-level corpectomy was 16.7° (59.7% of the preoperative value), for two-level corpectomy it was 20.0° (67.2%) and for three-level corpectomies it was 22.9° (74.3%). 63% of patients with lordotic spines continued to have lordosis postoperatively while only one became kyphotic without clinical worsening. Four patients with preoperative kyphotic spines showed no change in spine curvature. None developed spinal instability.

Conclusions

The OCC preserves segmental motion in the short-term, however, the tendency towards straightening of the spine, albeit without clinical worsening, warrants serial follow-up imaging to determine whether this motion preservation is long lasting.

Keywords

Cervical spondylotic myelopathy Ossified posterior longitudinal ligament Oblique corpectomy Motion preservation 

Notes

Conflict of interest

There are no sources of financial support or conflict of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ari George Chacko
    • 1
  • Mathew Joseph
    • 1
  • Mazda Keki Turel
    • 1
  • Krishna Prabhu
    • 1
  • Roy Thomas Daniel
    • 2
  • K. S. Jacob
    • 3
  1. 1.Section of Neurosurgery, Department of Neurological SciencesChristian Medical CollegeVelloreIndia
  2. 2.Service de NeurochirurgieCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
  3. 3.Department of PsychiatryChristian Medical CollegeVelloreIndia

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