The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform

Paul G Matz - One of the best experts on this subject based on the ideXlab platform.

  • Does nonoperative management play a role in the treatment of Cervical Spondylotic Myelopathy?
    The spine journal : official journal of the North American Spine Society, 2006
    Co-Authors: Paul G Matz
    Abstract:

    Cervical Spondylotic Myelopathy has traditionally been managed through surgical decompression with or without reconstruction. Currently, a multicenter, blinded clinical trial that has supported such a therapeutic recommendation does not exist. There have been case-control studies that have and have not shown long-standing benefit to surgical decompression and reconstruction. The purpose of this review is to examine the efficacy of nonoperative therapy for Cervical Spondylotic Myelopathy. It appears that both static and dynamic factors play a role in the pathophysiology of Cervical Spondylotic Myelopathy. Furthermore, once clinical Cervical Spondylotic Myelopathy is evident, progression may occur despite the best of treatments, both surgical and nonsurgical.

  • Does nonoperative management play a role in the treatment of Cervical Spondylotic Myelopathy
    The Spine Journal, 2006
    Co-Authors: Paul G Matz
    Abstract:

    Abstract Background context Cervical Spondylotic Myelopathy has traditionally been managed through surgical decompression with or without reconstruction. Currently, a multicenter, blinded clinical trial that has supported such a therapeutic recommendation does not exist. There have been case-control studies that have and have not shown long-standing benefit to surgical decompression and reconstruction. Purpose The purpose of this review is to examine the efficacy of nonoperative therapy for Cervical Spondylotic Myelopathy. Conclusions It appears that both static and dynamic factors play a role in the pathophysiology of Cervical Spondylotic Myelopathy. Furthermore, once clinical Cervical Spondylotic Myelopathy is evident, progression may occur despite the best of treatments, both surgical and nonsurgical.

T. A. Zdeblick - One of the best experts on this subject based on the ideXlab platform.

  • Cervical Spondylotic Myelopathy: Approaches to surgical treatment : Disorders of the Cervical Spine
    Clinical Orthopaedics and Related Research, 1999
    Co-Authors: R. D. Orr, T. A. Zdeblick
    Abstract:

    Cervical Spondylotic Myelopathy is the leading cause of spinal cord dysfunction in older patients. This review article looks at the natural history of the condition and examines the role of different surgical treatments for it. Anterior and posterior surgical approaches have a role in the treatment of Cervical Spondylotic Myelopathy dependent on the number of levels involved and the alignment of the spine. Anterior decompression and fusion is useful in patients who have disease at three or fewer levels or in patients with kyphotic alignment. In more extensive disease, a posterior decompression and fusion is usually best. Canal expansive laminoplasty is useful in the treatment of Myelopathy without radiculopathy in a patient with lordotic alignment. With the exception of laminoplasty, nonfusion procedures have little role in the treatment of Cervical Spondylotic Myelopathy.

  • Cervical Spondylotic Myelopathy. Approaches to surgical treatment.
    Clinical orthopaedics and related research, 1999
    Co-Authors: R. Orr, T. A. Zdeblick
    Abstract:

    Cervical Spondylotic Myelopathy is the leading cause of spinal cord dysfunction in older patients. This review article looks at the natural history of the condition and examines the role of different surgical treatments for it. Anterior and posterior surgical approaches have a role in the treatment

Li Yi-qiang - One of the best experts on this subject based on the ideXlab platform.

  • Anterior decompression and autograft fusion with plate fixation for multilevel Cervical Spondylotic Myelopathy
    Journal of Gannan Medical University, 2009
    Co-Authors: Li Yi-qiang
    Abstract:

    Objective:To analyze the practical value and efficacy of Cervical anterior decompression and autograft interbody fusion with an additional plate fixation for multilevel Cervical Spondylotic Myelopathy.Method: 30 cases of multilevel Cervical Spondylotic Myelopathy were treated by anterior multilevel decompression,interbody fusion,and plating were analysed retrospectively from March 2001 to March 2008.Result: 30 patients were followed up for 28 months in average.All fusion was determined at 12～16 weeks.Intervertebral spaces were restored after operation.The physiological curve of the Cervical spine was good.The effective rate of operation was 100%(30/30) and the excellent rate 93.3%(28/30).The JOA score rose from 8 points before operation to 16.5 points after operation.Conclusion: The curative effect was excellent in treating multilevel Cervical Spondylotic Myelopathy with anterior decompression and autograft fusion with plate fixation for multilevel Cervical Spondylotic Myelopathy.

Jia Lian-shun - One of the best experts on this subject based on the ideXlab platform.

  • Reconstructive techniques study after anterior decompression of multilevel Cervical Spondylotic Myelopathy.
    Journal of spinal disorders & techniques, 2009
    Co-Authors: Xu Wei-bing, Shen Wun-jer, Lv Gang, Zhu Yue, Jin Ming-xi, Jia Lian-shun
    Abstract:

    STUDY DESIGN Retrospectively compared 2 reconstructive techniques after the anterior decompression of multilevel Cervical Spondylotic Myelopathy. OBJECTIVE To clinically compare the biomechanical stability and neurologic results of 2 reconstructive techniques after the anterior decompression of multilevel Cervical Spondylotic Myelopathy retrospectively. SUMMARY OF BACKGROUND DATA Previous studies comparing different reconstruction techniques after the anterior decompression of multilevel Cervical Spondylotic Myelopathy have yielded mixed results. Some studies have reported a high incidence of graft-plate extrusion when 2 or more corpectomies are performed and reconstructed with a long segmental anterior plate fixation that spans the strut graft without supplemental posterior Cervical fixation, a standalone cage and segmental plate fixation after combination 1 level discectomy and 1 level corpectomy used to treat multilevel Cervical Spondylotic Myelopathy were reported have no evidence of late-onset instrumentation-related failure, although 2 techniques have never been directly compared in a consecutive series of patients clinically. METHODS A retrospective study of 59 patients with multilevel (3 levels) Cervical Spondylotic Myelopathy treated with 1 of 2 anterior decompression and reconstruction methods were compared. Copectomy method (39 patients) is 2-level corpectomies and long segment end-construct plate fixation; hybrid method (20 patients) is standalone cage and segmental plate fixation after 1-level discectomy combined with 1-level corpectomy. RESULTS The follow-up (mean18 mo) results show both methods had similar, satisfactory recovery of neurologic function (P>0.05). There were 7 cases of graft/plate migrations or dislodgments (17.9%) and 4 of these required revision surgery among 39 patients with corpectomy method, as compared with no graft/implant-related complications or nonunion among 20 patients with hybrid method (P

  • Evaluation of Surgical Treatment of Pinching Cervical Spondylotic Myelopathy
    The Orthopedic Journal of China, 2002
    Co-Authors: Jia Lian-shun
    Abstract:

    Objective: To evaluate effects of different surgical approaches to treat pinching Cervical Spondylotic Myelopathy. Method: 54 cases of pinching Cervical Spondylotic Myelopathy were included in this series from June 1996. Male 35 cases,female 21 cases. 42 cases were performed anterior decompression and fusion with autograft. 14 cases were performed posterior laminectomy to enlarge the spinal canal. All cases were followed up. Clinical statement of every case was evaluated by criteria of Japanese orthopedic association(JOA). Result: Improvement ratio of anterior decompression and fusion group was 57.33%±14.6%,excellent and good rate was 64.29%. Improvement rate of posterior laminectomy group was 37.35%±11.2%, excellent good rate was 42.86%.Conclusion: Anterior decompression and fusion with autograft to treat pinching Cervical Spondylotic Myelopathy was direct and effective. It should be the first choice of surgical treatment. Posterior approach should be the first choice when the patient was complicated with ligament flavum seriously degeneration, calcification or ossification; more than three segmental pathological changes or complicated with developmental canal stenosis. Otherwise anterior and posterior decompression by stages or one-stage should be performed.

Michael G. Fehlings - One of the best experts on this subject based on the ideXlab platform.

  • human neuropathological and animal model evidence supporting a role for fas mediated apoptosis and inflammation in Cervical Spondylotic Myelopathy
    Brain, 2011
    Co-Authors: Tianyi Liu, Timrasmus Kiehl, Michael G. Fehlings
    Abstract:

    Although Cervical Spondylotic Myelopathy is a common cause of chronic spinal cord dysfunction in humans, little is known about the molecular mechanisms underlying the progressive neural degeneration characterized by this condition. Based on animal models of Cervical Spondylotic Myelopathy and traumatic spinal cord injury, we hypothesized that Fas-mediated apoptosis and inflammation may play an important role in the pathobiology of human Cervical Spondylotic Myelopathy. We further hypothesized that neutralization of the Fas ligand using a function-blocking antibody would reduce cell death, attenuate inflammation, promote axonal repair and enhance functional neurological outcomes in animal models of Cervical Spondylotic Myelopathy. We examined molecular changes in post-mortem human spinal cord tissue from eight patients with Cervical Spondylotic Myelopathy and four control cases. Complementary studies were conducted using a mouse model of Cervical Spondylotic Myelopathy (twy/twy mice that develop spontaneous cord compression at C2-C3). We observed Fas-mediated apoptosis of neurons and oligodendrocytes and an increase in inflammatory cells in the compressed spinal cords of patients with Cervical Spondylotic Myelopathy. Furthermore, neutralization of Fas ligand with a function-blocking antibody in twy/twy mice reduced neural inflammation at the lesion mediated by macrophages and activated microglia, glial scar formation and caspase-9 activation. It was also associated with increased expression of Bcl-2 and promoted dramatic functional neurological recovery. Our data demonstrate, for the first time in humans, the potential contribution of Fas-mediated cell death and inflammation to the pathobiology of Cervical Spondylotic Myelopathy. Complementary data in a murine model of Cervical Spondylotic Myelopathy further suggest that targeting the Fas death receptor pathway is a viable neuroprotective strategy to attenuate neural degeneration and optimize neurological recovery in Cervical Spondylotic Myelopathy. Our findings highlight the possibility of medical treatments for Cervical Spondylotic Myelopathy that are complementary to surgical decompression.

  • Cervical Spondylotic Myelopathy: surgical outcomes in the elderly
    International Journal of Clinical Rheumatology, 2010
    Co-Authors: David W. Cadotte, Alina Karpova, Michael G. Fehlings
    Abstract:

    Cervical Spondylotic Myelopathy is a progressive degenerative condition of the Cervical spine that results in neurological deficit in either an acute or a delayed fashion. It is the most common disease process that affects the spinal cord in those aged 55 years or above. In this article we discuss the pathophysiology of the condition and highlight symptoms, timing of presentation and clinical indications. With a particular emphasis on the elderly patient, defined most often as those above 60–70 years of age, we discuss prognostic indicators, surgical treatment options and patient outcomes. This article concludes with a discussion of certain medical conditions that particularly affect the elderly patient and a discussion of future perspectives in Cervical Spondylotic Myelopathy research.

  • A review of the pathophysiology of Cervical Spondylotic Myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury
    Spine, 1998
    Co-Authors: Michael G. Fehlings, Ghassan Skaf
    Abstract:

    Cervical Spondylotic Myelopathy (CSM) is the most common cause of spinal cord dysfunction. Despite advances in diagnosis and surgical treatment, many patients still have severe permanent neurologic deficits caused by this condition. An improved understanding of the pathophysiology of Cervical Spondylotic Myelopathy, particularly at a cellular and molecular level, may allow improved treatments in the future. A detailed review of articles in the literature pertaining to Cervical Spondylotic Myelopathy was supplemented by an analysis of relevant mechanisms of spinal cord injury. The pathologic course of Cervical Spondylotic Myelopathy is characterized by early involvement of the corticospinal tracts and later destruction of anterior horn cells, demyelination of lateral and dorsolateral tracts, and relative preservation of anterior columns. Static and mechanical factors and ischemia are critical to the development of Cervical Spondylotic Myelopathy. Free radical-and cation-mediated cell injury, glutamatergic toxicity, and apoptosis may be of relevance to the pathophysiology of Cervical Spondylotic Myelopathy. To date, research in Cervical Spondylotic Myelopathy has focused exclusively on the role of mechanical factors and ischemia. Fundamental research at a cellular and molecular level, particularly in the areas of glutamatergic toxicity and apoptosis may result in clinically relevant treatments for this condition.