Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study.

  title={Efficacy and safety of surgical decompression in patients with cervical spondylotic myelopathy: results of the AOSpine North America prospective multi-center study.},
  author={Michael G. Fehlings and Jefferson R. Wilson and Branko Kopjar and Sangwook T. Yoon and Paul M. Arnold and Eric M. Massicotte and Alexander R. Vaccaro and Darrel S. Brodke and Christopher I Shaffrey and Justin S. Smith and Eric J. Woodard and Robert J. Banco and Jens Robert Chapman and Michael E. Janssen and Christopher M Bono and Rick C. Sasso and Mark B. Dekutoski and Ziya L. Gokaslan},
  journal={The Journal of bone and joint surgery. American volume},
  volume={95 18},
BACKGROUND Cervical spondylotic myelopathy is the leading cause of spinal cord dysfunction worldwide. The objective of this study was to evaluate the impact of surgical decompression on functional, quality-of-life, and disability outcomes at one year after surgery in a large cohort of patients with this condition. METHODS Adult patients with symptomatic cervical spondylotic myelopathy and magnetic resonance imaging evidence of spinal cord compression were enrolled at twelve North American… 

Tables from this paper

A Global Perspective on the Outcomes of Surgical Decompression in Patients With Cervical Spondylotic Myelopathy: Results From the Prospective Multicenter AOSpine International Study on 479 Patients

Surgical decompression for CSM is safe and results in improved functional status and quality of life in patients around the world, irrespective of differences in medical systems and sociocultural determinants of health.

Efficacy and Safety of Surgery for Mild Degenerative Cervical Myelopathy: Results of the AOSpine North America and International Prospective Multicenter Studies

Mild DCM is associated with significant impairment in quality of life, and surgery results in significant gains in functional status, level of disability, and quality oflife.

Effectiveness of Surgical Decompression in Patients With Degenerative Cervical Myelopathy: Results of the Canadian Prospective Multicenter Study.

At 12 mo after surgery, patients with mild, moderate, and severe DCM all demonstrated improved outcomes and the proportion of patients in each severity group achieving clinically meaningful changes did not differ significantly across most outcome measures.

Comparison of Outcomes of Surgical Treatment for Ossification of the Posterior Longitudinal Ligament Versus Other Forms of Degenerative Cervical Myelopathy: Results from the Prospective, Multicenter AOSpine CSM-International Study of 479 Patients.

Surgical decompression for the treatment of OPLL resulted in improvements in functional status and quality of life comparable to those seen in patients with other forms of DCM, which is unclear whether surgery is equally effective and safe for patients with OPLL.

The impact of preoperative neurological symptom severity on postoperative outcomes in cervical spondylotic myelopathy

Although patients with moderate-to-severe myelopathy improved for all outcomes, they did not achieve normal absolute neurological function, indicating potential irreversible spinal cord changes.

Comparison of the effect of anterior and posterior neurosurgical treatment for cervical spondylotic myelopathy: a clinical outcome

It is demonstrated that even severely disabled patients have a good chance of neurologic recovery after surgical treatment for CSM, and clinical decision-making in the series was adequate.

Predictors of Return to Normal Neurological Function After Surgery for Moderate and Severe Degenerative Cervical Myelopathy: An Analysis of A Global AOSpine Cohort of Patients.

In this study, T1W-hypointensity on MRI and longer walking time were found to predict a less likelihood of achieving return to normal neurological function after surgery for moderate or severe DCM.

Outcome of operative management of degenerative compressive myelopathy of cervical spine

While comparing the functional outcome for anterior and posterior procedures using 6month, 1 year and 2 year postoperative mJOA score and European myelopathy score, result is significantly better for posterior procedures than anterior procedures (p values <0.05).

Baseline severity of myelopathy predicts neurological outcomes after posterior decompression surgery for cervical spondylotic myelopathy: a retrospective study.

The combination of the baseline severity of myelopathy and age can predict postoperative symptom states after posterior decompression surgery for cervical spondyloticMyelopathy in people around the mean age of the study cohort.

Efficacy of surgical treatment in patients with cervical spondylotic myelopathy

Surgical treatment of patients with symptomatic CSM in a single institution resulted in a significant improvement in all outcome measures for a 1-year follow-up period and could be recommended to evaluate the course of the disease, define the optimal surgical strategy, and better determine surgical outcome predictors.



Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up.

Approaches to Spondylotic Cervical Myelopathy: Conservative Versus Surgical Results in a 3-year Follow-up Study

The 3-year follow-up study did not show, on the average, that the surgery is superior to conservative treatment for mild and moderate forms of spondylotic cervical myelopathy.


The results of the current study suggest that OC is a good alternative to conventional median corpectomy and fusion techniques in selected cases and achieved good results with a low morbidity rate.

Operative treatment of cervical spondylotic myelopathy and radiculopathy. A comparison of laminectomy and laminoplasty at five year average follow-up.

It is believed that laminoplasty is an effective alternative to laminectomy in patients with multi-level cervical spondylotic myelopathy or radiculopathy and was associated with fewer late complications.

Relationships Between Outcomes of Conservative Treatment and Magnetic Resonance Imaging Findings in Patients With Mild Cervical Myelopathy Caused by Soft Disc Herniations

Conservative treatment is an effective treatment option for mild cervical myelopathy caused by cervical soft disc herniation and a good outcome can be expected in patients with a median-type and/or diffuse-type herniated on magnetic resonance imaging.

How beneficial is surgery for cervical radiculopathy and myelopathy?

Spondylotic degeneration of the cervical spine is associated with ageing and is often asymptomatic,1 but 10-15% of people with the condition might develop symptoms of compression of the nerve roots

Surgical decompression for cervical spondylotic myelopathy: correlation between operative outcomes and MRI of the spinal cord.

Analysis of the pre- and postoperative magnetic resonance imaging findings and the Japanese Orthopedic Association score showed that type 0 and type 1 intramedullary high-signal intensity indicates better prognosis than type 2.

Surgery for cervical radiculopathy or myelopathy.

Whether surgical treatment of cervical radiculopathy or myelopathy is associated with improved outcome, compared with conservative management and timing of surgery (immediate or delayed pending persistence/progression of relevant symptoms and signs) has an impact on outcome is investigated.

Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy.

The data presented here suggests that myelopathic patients with a cervical kyphosis are best treated with an ACDF and that Patients with a normal cervical lordosis arebest treated with a posterior approach.

Cervical spondylotic myelopathy.

A review of common diagnoses of spinal cord disorders showed spondylotic cervical myelopathy to be the most common diagnosis, and questions remain in the practical application of this knowledge.