gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Cervical myelopathy: surgical techniques and indications

Meeting Abstract

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  • corresponding author G. Matgé - Service de Neurochirurgie, Centre Hospitalier de Luxembourg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocRT.08.03

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Matgé.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




The aim is to analyse different surgical techniques and indications concerning recalibration of the stenotic spinal canal in cervical myelopathy.


Decompression of the cervical spinal cord may be achieved different routes according to dominant anatomical lesions. The anterior approach allows enlarged discectomy with foraminotomy. Interbody fusion gives stability to motion segments reinforced by plating required in case of kyphosis or lithesis. More extended compression demands vertebral body resection with or without reconstruction. Posterior approaches include classical or instrumented laminectomy and numerous techniques of laminoplasty.


Anterior approaches address directly the offending lesions in 75%, and allow sagittal balance conservation or restoration contrary to posterior decompression more frequently complicated by postoperative kyphosis and secondary reaggravation of myelopathy. Short segment stenosis up to 3 levels, loss of lordosis and dominance of upper limbs lesion are good indications. Enlarged discectomy relieves neural compression, with a fear of secondary kyphosis avoided by interbody fusion. Kyphosis correction is best achieved with anterior plating. In severe stenosis and OPLL, corpectomy fulfils excellent decompression at the price of a long graft or adapted spacers and anterior plating. An intermediate fixation enhances stability and reduces failure. Posterior approaches are favoured in multilevel stenosis with dominant cordonal signs (lower limbs). Traditional laminectomy is a straight procedure in the more morbid elderly population. Laminoplasties of different types achieve same decompression with less kyphotic deformity, less instability, and some protection of degeneration in adjacent levels. Mixed approaches are indicated in severe stenosis of congenital origin, failed surgeries by insufficient decompression.


Decompression of the spinal cord is the primary goal as long as the operation is timely indicated. Recalibration of the stenotic canal may be achieved by different techniques owing to anatomical location of dominant lesion, number of affected segments, clinical condition of the patient and experience of the surgeon. A sound reasoning should avoid expectable complications, using micro-techniques and modern instrumentation.