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The two common reasons for needing elective cervical surgery are because of

  1. pressure on the nerves as they leave the spine - Radiculopathy
  2. pressure on the spinal cord - Myelopathy

Radiculopathy – Pain that radiates from the spine proximally, extending outwards with numbness and paraesthesia along the dermatome.

Myelopathy – Weakness/stiffness and clumsiness of both the upper and lower limbs with variable impairment of sensations below the level of the compression of the spinal cord. (Pain is not a big feature)

How does one decide what surgery is required for the cervical spine problem?

  • When the nerve is being compressed by a bony spur from in front - we approach from the front.
    • Anterior cervical discectomy and fusion
    • Anterior cervical discectomy and arthrodesis
    • Anterior cervical corpectomy and fusion
  • If the compression is from the front for more than 2 vertebral levels the tendency is to relieve pressure by operating from the back.
    • Laminectomy
  • If there is a suggestion of excessive degeneration or instability, a fusion is usually done.

  • royal-australasian-college-of-surgeons
  • flinders-medical-centre
  • cmc-vellore
  • calvary-adelaide-hospital
  • Neurosurgical Research Foundation