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dc.titleManagement Of Degenerative Cervical Myelopathy: An Updateen
dc.contributor.authorAndrei F.; Ghizonipt_BR
dc.contributor.authorEnrico; Tedeschipt_BR
dc.contributor.authorHelder; Hsupt_BR
dc.contributor.authorWellington K.; Patelpt_BR
dc.contributor.authorAlpesh A.pt_BR
unicamp.authorTedeschi, Helder] Univ Estadual Campinas Unicamp, Dept Neurol, Neurosurg Div, Campinas, SP, Brazilpt_BR[Joaquim, Andrei F.pt_BR, Enricopt_BR[Hsu, Wellington K.pt_BR, Alpesh A.] Northwestern Univ, Dept Orthopaed Surg, Chicago, IL 60611 USApt_BR
dc.subjectCervical Myelopathyen
dc.subjectSpondylotic Myelopathyen
dc.subjectSurgical Approachen
dc.subjectAnterior Approachen
dc.subjectPosterior Approachen
dc.description.abstractDegenerative 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.en
dc.relation.ispartofRevista da Associacao Medica Brasileirapt_BR
dc.publisherAssociação Médica Brasileirapt_BR
dc.publisherSão Paulopt_BR
dc.identifier.citationRevista Da Associacao Medica Brasileira . Associação Médica Brasileira, v. 62, p. 886 - 894, 2016.pt_BR
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