Operative Treatment of Kyphosis and Multilevel Degenerative Process in the Neck Area of the Spine within Treatment or Prevention of Cervical Myelopathy

Disruption of static balance of the spinal column leads to physiological disorders of the lumbar lordosis. This affects the long-term loss of physiological lordosis of the cervical spine with the development of degenerative processes and the formation of kyphosis. Clinical signs are a consequence of the compression of the neurovascular multisegmental elements in lateral recessusses, as well as the compression of the spinal cord itself into the spinal canal. A long-term conservative approach in the treatment of degenerative diseases multilevel door had questionable results. All patients were present progressive neurological deterioration.

Surgery was performed in 56 patients with polisegment degenerative processes and clear signs of cervical kyphosis: 23 on two levels, 21 on 3 levels and 12 levels in 4 patients were surgically treated in the period from 2010 to 2015. All patients were treated with anterior multilevel operational approach. It was made complete release intervertebral area with removing osteophytes from the lateral recessus, the rear longitudinal ligament resection, or removing marginal osteophytes from the vertebral canal. At each level thereafter, distraction and insertion titanium cage were made, along with a complete correction of cervical kyphosis. Required is made front stabilization titanium plate.

Postoperative follow-up of patients was done at least a year. Immediate postoperative clinical and radiological evaluations were done (RTG doors and MSCT cervical spine). After 6 weeks and 3, 6, and 12 months, control with X-ray cervical spine and EMG and evoked potentials. Six-month NMR cervical spine was performed.

All patients had a greater or lesser recovery with a stop progression of neurologic deficit. In patient 6, paciejnata was a problem with swallowing for a prolonged period. In patient 2, revisions were made due to falling titanium grefona destabilization in cabinets with front fixation plate. Two patients underwent a new operational approach to smisku enlargement level, access from two to three levels and three to four levels. It was observed that in spite of multilevel access, only 12 patients registered the problem with the volume rotation gate, but with them it did not affect the normal life activities. Polisegment degenerative processes with a pronounced cervical kyphosis and genuine chronic pain syndrome and neurological disturbances belong to the absolute indication for multisegmental operational approach, as the only possible way to prevent compression of progressive neuromuscular diseases.