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A New Doorway to Relieve Cervical Myelopathy

Disc problems commonly affect the low back. Less often, disc material can press against the spinal cord of the neck. This is called cervical myelopathy. Myelopathy can cause problems with the bowels and bladder, change the way you walk, and affect your ability to use your fingers and hand.

When all other treatment has failed, surgery is the next step for cervical myelopathy. The best surgical method for this problem is unknown. Surgeons have tried many different ways to take the pressure off the spinal cord. This is hard to do without causing other problems in the neck.

A group of doctors at a large spine center compared two methods of surgery for cervical myelopathy. The first is called cervical corpectomy and involves removing the front of the spine bone, the vertebral body. A bone graft is put in its place and fused to the vertebra above and below it.

The second surgery is called laminoplasty. In this operation, the doctor removes a piece of bone over the back of the spinal cord. This covering of bone is called the lamina. There are two laminae for each vertebra, one on each side. By cutting all the way through one lamina and making a hinge on the other, this section of bone can be opened like a door. This takes the pressure off the spinal cord.

Corpectomy and laminoplasty can keep myelopathy from getting worse. The laminoplasty has fewer complications after surgery. Patients have better motion and uses fewer medications after a laminoplasty.

The first study to compare results of surgery in the neck for cervical myelopathy has been reported. Only two of the possible methods were compared. Both had similar results, but laminoplasty had fewer problems after surgery.

References: Charles C. Edwards II, MD, et al. Corpectomy Versus Laminoplasty for Multilevel Cervical Myelopathy. An Independent Matched-Cohort Analysis. In Spine. June 1, 2002. Vol. 27. No. 11. Pp. 1168-1175.

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