Servikal Spondilotik Myelopati
Özet
82 yaşındaki bir kadın hasta, düşme sonrası gelişen ciddi kuvvet kaybı ve çok seviyeli servikal stenoz ile myelopati nedeniyle tedavi edilmiştir. Tedavide nöral dekompresyonu sağlamak ve omurgayı stabilize etmek amacıyla hem posterior laminektomi ve vidalama hem de anterior korpektomi ve plak uygulaması içeren kombine bir cerrahi yaklaşım tercih edilmiştir. Bu operasyon sonucunda hastanın nörolojik durumu iyileşmiş, sagital denge sağlanmış ve hasta bir ay süren fizik tedavi sonrasında yardımsız yürümeye başlamıştır.
An 82-year-old female patient was treated for severe limb weakness and multi-level cervical stenosis with myelopathy following a fall. The treatment involved a combined surgical approach, including posterior laminectomy with stabilization and anterior corpectomy with plating, to achieve neural decompression and spinal stability. Following the procedure, the patient's neurological status improved, sagittal balance was restored, and she regained the ability to walk independently after one month of physical therapy.
Referanslar
Pescatori L, Tropeano MP, Visocchi M, Grasso G, Ciappetta P. Cervical Spondylotic Myelopathy: When and Why the Cervical Corpectomy? World Neurosurg. 2020 Aug;140:548-555.
Goel A, Grasso G, Shah A, Rai S, Dandpat S, Vaja T, Jadhav D, Jadhav N. "Only Spinal Fixation" as Surgical Treatment of Cervical Myelopathy Related to Ossified Posterior Longitudinal Ligament: Review of 52 Cases. World Neurosurg. 2020 Aug;140:556-563.
Kim PK, Alexander JT. Indications for circumferential surgery for cervical spondylotic myelopathy. Spine J. 2006 Nov-Dec;6(6 Suppl):299S-307S
Bram R, Fiore S, Labiak JJ, Davis RP. Combined Anterior-Posterior Decompression and Fusion for Cervical Spondylotic Myelopathy. Am J Orthop (Belle Mead NJ). 2017 Mar/Apr;46(2):E97-E104
Kim PK, Alexander JT. Indications for circumferential surgery for cervical spondylotic myelopathy. Spine J. 2006 Nov-Dec;6(6 Suppl):299S-307S
Bram R, Fiore S, Labiak JJ, Davis RP. Combined Anterior-Posterior Decompression and Fusion for Cervical Spondylotic Myelopathy. Am J Orthop (Belle Mead NJ). 2017 Mar/Apr;46(2):E97-E104.
Song KJ, Johnson JS, Choi BR, Wang JC, Lee KB. Anterior fusion alone compared with combined anterior and posterior fusion for the treatment of degenerative cervical kyphosis. J Bone Joint Surg Br. 2010;92(11):1548-1552.
