gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Posterior decompression and instrumentation for failed anterior surgery in CSM?: a case review

Meeting Abstract

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  • corresponding author R. Schmidt - Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm, Ulm
  • W. Puhl - Ulm
  • B. Cakir - Ulm

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP114

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

Published: June 13, 2005

© 2005 Schmidt et al.
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.




Anterior cervical decompression and interbody arthrodesis is a generally accepted tool to handle CSM in single level involvement. In the presence of multilevel stenosis corpectomy or a posterior access seems preferable. The approach for reoperations when necessary is less clear. Report of two cases.


2 males 62 years old with anterior decompression and fusion C3/4 and C4-C6 due to CSM with persistent paraesthesia and neck pain over 8 months in one case and fast progressive myelopathy (Nurick grade 5) in 11 days in the other case were admitted to our hospital. Diagnostics revealed persistent spinal stenosis. Posterior decompression by laminectomy and instrumentation with rigid screw and rod system with lateral mass screws was perfomed. Paraesthesias and neck pain as well as myelopathy (Nurick grade 0) improved.


The posterior access after insufficient anterior decompression is a effective tool for reoperations in case of early and late deterioration. Benefits are the easier approach due to missing scar tissue, additional removal of posterior compression and no need for removal of anterior instrumentation, which can be difficult in case of a solid fusion, especially with additional hardware, e.g. cages.