Informace o publikaci

Spondylotic cervical myelopathy- clinical aspects



Rok publikování 2003
Druh Kapitola v knize
Fakulta / Pracoviště MU

Lékařská fakulta

Popis Spondylotic cervical myelopathy is the most frequent cause of cervical myelopathy in the population over 15 years of age. What makes the SCM clinically so loaded is its potentially malignant natural course and the potentially calamitous results of surgery. The treatment of SCM is a matter of controversy in the literature. Surgery is logical response to the stenotic process, but no good evidence exists that decompressive surgery with anterior or posterior approach can improve the clinical outcome for the victims of this disease. Prospective studies of the surgical approach to this disease are generally lacking.. The results of our randomised prospective study did not show any important difference between the outcome for patients with mild and moderate forms of SCM treated surgically or conservatively over a 36-month period. Neither of these methods can prevent an unfavourable course for a proportion (20-30%) of these patients. The possibility remains (besides efforts to improve our therapeutic armamentarium) of analysing a group of patients responding positively or negatively to conservative and surgical treatment and to assess the prediction factors for good or bad outcomes, i.e. to find measures enabling the choice of patients who may profit from the conservative or from the surgical approach. We are at the point of finalising a study that could address this question.
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