Multilevel Corpectomy for Cervical Spondylotic Myelopathy

Abstract

Multilevel corpectomy for decompressing the spinal cord to treat cervical spondy-lotic myelopathy has become commonplace. Correlation of preoperative radiographic findings with intraoperative anatomy will ensure adequate decompression and lessen complications. Reconstruction with cadaveric fibula or bone-filled titanium cages combined with a locking cervical plate has reduced donor site morbidity and long-term construct failure to near zero for two-level corpectomies. Three or more levels may best be reconstructed by both anterior and posterior instrumentation. One of the more common complications of this operation is hoarseness and that may be lessened with endotracheal tube deflation during retraction. Most of the complications of surgery are minor (including dysphagia), improve with time, and are well tolerated by the patient. The preoperative myelopathic gait improves in 50% and upper extremity weakness/spasticity improves in 70% of patients.