الفهرس | Only 14 pages are availabe for public view |
Abstract Cervical spondylotic myelopathy is a hidden complication of cervical degenerative disease that usually discovered incidentally in outpatient clinics. Many factors contribute to the development 0f this catastrophic sequel may be static or dynamic or both. Most of patients complain of decreased hand dexterity and fine movement, also some experienced abnormal gait pattern. Obvious signs of cervical myelopathy are upper limb hyper-reflexia, Hoffman sign, inverted radial reflex, finger escape sign, 15 s grip release test and lower limb signs are clonus and Babiniski sign. Many imaging modalities could be used in diagnosis of CSM like, x-ray flexion, extension, oblique views and CT to detect osteophytes formation and OPLL disease. MRI is the study of choice in CSM that can detect level of disc prolapse and degree of cervical spinal canal stenosis and cord signal changes that may predict the prognosis of this condition. Many surgical techniques used in the management of CSM, may be anterior surgeries: ACDF, ACCF, and cervical disc prosthesis and also posterior surgeries: laminectomy, laminectomy with fusion and laminoplasty. The site of the offending structures, number of levels and the cervical sagittal balance are very important factors that rule the way of surgical interference. Aim of the study: This study was conducted on 25 patients in Fayoum university hospitals to evaluate the functional outcome of stand-alone cage in the management of spondylotic cervical myelopathy, clinically by Vas & Summary 2 | Page Mjoa score and radiologically to detect fusion rate, improvement and maintenance of cervical sagittal balance. Inclusion Criteria: - Age: 30-70 y and both sexes are involved. - Patients with spondylotic cervical myelopathy with Single or multiple level disc prolapse. Exclusion Criteria: - Patients with compressive cervical non-spondylotic myelopathy. - A major instability that required anterior and posterior approach. |