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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Smith-Robinson Procedure with and without Caspar Plating as a Treatment for Cervical Spondylotic Myelopathy: A 26 year follow-up of 23 patients

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  • Benedikt Burkhardt - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Moritz Brielmaier - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Karsten Schwerdtfeger - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Joachim Oertel - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 003

doi: 10.3205/17dgnc566, urn:nbn:de:0183-17dgnc5667

Published: June 9, 2017

© 2017 Burkhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The purpose of this study was to assess long-term follow-up data after anterior cervical decompression and fusion (ACDF) with and without Caspar plating (ACDF+PS) for the treatment of cervical spondylotic myelopathy (CSM) with special focus on functional outcome, pain, and repeat surgery for adjacent segment disease (ASD).

Methods: Hospital records of 45 patients who were affected by CSM and underwent ACDF or ACDF+PS at least 17 years ago were reviewed. Information about diagnosis, surgical report, pre- and postoperative clinical process, and complications was analyzed. Clinical outcome was assessed using a standardized questionnaire including the Neck Disability Index (NDI), modified JOA-score, Odom’s criteria, limitations in quality of life, and questions about the current neurological status and pain.

Results: Twenty-three patients with a mean follow-up of 26 years were evaluated. ACDF was performed in nine and ACDF+PS in 14 patients, respectively. At follow-up 87.0 of patients were free of pain, 91.3% had no motor deficit, 73.9% had no sensory deficit, and 60.7% had no gait disturbance. The current mean NDI is 14% (range 2-44%), the mean modified JOA-score was 17.2 (range 15-18). According to Odom’s criteria 78.3% of patients had clinical success. In four patients repeat surgery was indicated due to pseudarthrosis or symptomatic ASD (17.4%).

Conclusion: ACDF and ACDF+PS yield significant decrease in neck pain, a significant increase in sensorimotor function and a high rate of clinical success. Patients with preoperative gait disturbance completely recovered in about 60% of cases. Overall prevalence for ASD was 17.4% after 25 years.