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Nader S. Dahdaleh, Albert P. Wong, Zachary A. Smith, Ricky H. Wong, Sandi K. Lam, and Richard G. Fessler

hospitalization time. 3 We have used a minimally invasive technique to treat certain cases of cervical spondylotic myelopathy. The patients are primarily those who have acceptable preoperative effective cervical lordosis, 6 whose preoperative flexion-extension radiographs do not indicate abnormal motion, and whose radiographs do not show segmental listhesis. The technique involves a unilateral paramedian approach through small incisions, with minimal muscle dissection, through which decompressive single or multilevel bilateral hemilaminotomies are achieved with total

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Neurosurgical Forum: Letters to the Editor To The Editor Paul R. Cooper , M.D. New York University School of Medicine New York, New York 253 254 Abstract Object. Investigators reporting decompressive surgery to treat patients with cervical spondylotic myelopathy (CSM) have described inconsistent benefits. In the present study the authors used three types of outcomes instruments to assess the results of CSM surgery. Methods. The authors collected prospective baseline and 6-month follow-up data in a cohort of

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Saman Shabani, Mayank Kaushal, Matthew D. Budde, Marjorie C. Wang, and Shekar N. Kurpad

, Le Thuc V , Duhamel A , Assaker R , Cotten A : Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy . Eur Radiol 21 : 426 – 433 , 2011 5 Carballido-Gamio J , Xu D , Newitt D , Han ET , Vigneron DB , Majumdar S : Single-shot fast spin-echo diffusion tensor imaging of the lumbar spine at 1.5 and 3 T . Magn Reson Imaging 25 : 665 – 670 , 2007 6 Cui JL , Li X , Chan TY , Mak KC , Luk KD , Hu Y : Quantitative assessment of column-specific degeneration in cervical spondylotic myelopathy

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Eyal Behrbalk, Khalil Salame, Gilad J. Regev, Ory Keynan, Bronek Boszczyk, and Zvi Lidar

C ervical spondylotic myelopathy refers to spinal cord dysfunction, the clinical presentations of which range from mild axial neck pain to gross sensory loss, motor weakness, spastic gait, fine motor impairment, and loss of sphincter control. 7 , 10 , 19 Cervical spondylotic myelopathy is the most common cause of acquired spastic paresis in adults older than 55 years. 4 , 6 , 10 , 16 The most common cause of CSM is age-related cervical spinal stenosis 1 with slow disease progression deteriorating in a stepwise fashion. 5 , 12 Patients typically report

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Izabela Aleksanderek, Todd K. Stevens, Sandy Goncalves, Robert Bartha, and Neil Duggal

L , Hadden T : Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy . J Spinal Disord 4 : 286 – 295 , 1991 1802159 10.1097/00002517-199109000-00005 5 Blinkenberg M , Bonde C , Holm S , Svarer C , Andersen J , Paulson OB , : Rate dependence of regional cerebral activation during performance of a repetitive motor task: a PET study . J Cereb Blood Flow Metab 16 : 794 – 803 , 1996 10.1097/00004647-199609000-00004 8784224 6 Brock JH , Rosenzweig ES , Blesch A , Moseanko R , Havton LA

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Sait Naderi, Edward C. Benzel, and Nevan G. Baldwin

Cervical spondylotic myelopathy can produce a variety of clinical signs and symptoms secondary to neural compromise and biomechanical involvement of the spine. The surgical treatment of cervical spondylotic myelopathy remains a controversial issue after many years of study, evolution, and refinement. Several ventral, dorsal, or combined approaches have been defined. The complications associated with ventral approaches and the concerns about kyphosis following dorsal approaches led to the development of a variety of laminoplasty procedures. This paper reviews the biomechanical basis of cervical spondylotic myelopathy and its effect on choosing the appropriate surgical approach.

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Michael G. Fehlings, Justin S. Smith, Branko Kopjar, Paul M. Arnold, S. Tim Yoon, Alexander R. Vaccaro, Darrel S. Brodke, Michael E. Janssen, Jens R. Chapman, Rick C. Sasso, Eric J. Woodard, Robert J. Banco, Eric M. Massicotte, Mark B. Dekutoski, Ziya L. Gokaslan, Christopher M. Bono, and Christopher I. Shaffrey

the surgical treatment of CSM based on a prospective multicenter study and to determine clinical and surgical factors associated with the occurrence of perioperative complications. Methods Patient Population The AOSpine North America Cervical Spondylotic Myelopathy Study is a recently completed prospective, multicenter study of patients surgically treated for CSM. 9 A total of 302 symptomatic patients with radiographically confirmed CSM were enrolled at 12 sites in the United States and 1 site in Canada between December 2005 and September 2007

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Matthew D. Alvin, Daniel Lubelski, Edward C. Benzel, and Thomas E. Mroz

of patients with CSM who were included in the AOSpine North America Cervical Spondylotic Myelopathy Study (n = 70 cases; 45 patients in the ventral fusion cohort and 19 in the dorsal fusion cohort; 6 patients had both). The QOL outcomes measured by the mJOA (3-point increase), NDI (11-point decrease), SF-36 (5-point increase), and SF-6D (0.07-point increase) all showed significant (p < 0.0001) improvement by 1 year postoperatively. Thus, in agreement with Ghogawala et al., they found that surgical management of CSM produces significantly improved QOL outcomes

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Arthur R. Kurzbuch, Benedict Rilliet, Maria-Isabel Vargas, Colette Boex, and Enrico Tessitore

M agnetic resonance imaging plays a decisive role in the evaluation of pathologies of the spine and the spinal cord. Cervical spondylotic myelopathy is a frequent pathology in most cases of degenerative stenosis of the cervical spine caused by disc protrusions, herniated discs, or hypertrophy of ligaments. High signal intensity on T2-weighted images 1 , 13 and (to a much lesser extent) contrast enhancement 10 , 13 are the MR imaging features of CSM due to chronic spinal cord compression. When contrast enhancement is found in cases of CSM, neoplastic

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Katsuhiro Onari, Soichi Kondo, Hisanori Mihara, and Yuichi Iwamura

Cord 36: 288–292, 1998 11. Kojima S , Tohma S , Hattori T , et al : [Neurological impairments of adults with cervical spondylosis with athetotic cerebral palsy.] Clin Neurol 22 : 832 – 839 , 1982 (Jpn) Kojima S, Tohma S, Hattori T, et al: [Neurological impairments of adults with cervical spondylosis with athetotic cerebral palsy.] Clin Neurol 22: 832–839, 1982 (Jpn) 12. Kurose Y , Matsumoto Y , Murata H , et al : Treatment of cervical spondylotic myelopathy in athetoid cerebral