Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/330050
Type: Artigo
Title: Management Of Degenerative Cervical Myelopathy: An Update
Management of degenerative cervical myelopathy: an update
Title Alternative: Manejo da mielopatia cervical degenerativa – uma atualização
Author: Joaquim, Andrei F.
Ghizoni, Enrico
Tedeschi, Helder
Hsu, Wellington K.
Patel, Alpesh A.
Abstract: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adult patients. Patients generally present with a slow, progressive neurological decline or a stepwise deterioration pattern. In this paper, we discuss the most important factors involved in the management of DCM, including a discussion about the surgical approaches. Method: The authors performed an extensive review of the peer-reviewed literature addressing the aforementioned objectives. Results: Although the diagnosis is clinical, magnetic resonance imaging (MRI) is the study of choice to confirm stenosis and also to exclude the differential diagnosis. The severity the clinical symptoms of DCM are evaluated by different scales, but the modified Japanese Orthopedic Association (mJOA) and the Nurick scale are probably the most commonly used. Spontaneous clinical improvement is rare and surgery is the main treatment form in an attempt to prevent further neurological deterioration and, potentially, to provide some improvement in symptoms and function. Anterior, posterior or combined cervical approaches are used to decompress the spinal cord, with adjunctive fusion being commonly performed. The choice of one approach over the other depends on patient characteristics (such as number of involved levels, site of compression, cervical alignment, previous surgeries, bone quality, presence of instability, among others) as well as surgeon preference and experience. Conclusion: Spine surgeons must understand the advantages and disadvantages of all surgical techniques to choose the best procedure for their patients. Further comparative studies are necessary to establish the superiority of one approach over the other when multiple options are available.
Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adult patients. Patients generally present with a slow, progressive neurological decline or a stepwise deterioration pattern. In this paper, we discuss the most
metadata.dc.description.abstractalternative: A mielopatia cervical degenerativa (MCD) é uma das causas mais comuns de disfunção medular em adultos. Os pacientes em geral apresentam declínio neurológico lento e progressivo, ou deterioração escalonada. No presente artigo, discutimos os mais importante
Subject: Cervical Myelopathy
Spondylotic Myelopathy
Surgical Approach
Anterior Approach
Posterior Approach
Diagnóstico diferencial
Country: Brasil
Editor: Associação Médica Brasileira
Citation: Revista Da Associacao Medica Brasileira . Associação Médica Brasileira, v. 62, p. 886 - 894, 2016.
Rights: Aberto
Identifier DOI: 10.1590/1806-9282.62.09.886
Address: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302016000900886
Date Issue: 2016
Appears in Collections:FCM - Artigos e Outros Documentos

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