Artem GushchaRussian Academy of Medical Sciences, Russian Fedration
Title: Minimally invasive surgery and modern view on the treatment of degenerative spine diseases
Introduction: Cervical spondylogenic myelopathy (CSM) is a manifestation of extended cervical spinal stenosis and is characterize by severe neurological disorders. Given the high disability and ineffectiveness of conservative treatment of CSM, it is preferable to perform surgical intervention aimed at decompression of the spinal canal. Currently, two surgical treatment tactics compete – laminoplasty and corporectomy.
Objective: To analyze of early (1st day after surgery) and long-term (12, 60 months after surgery) clinical, radiological and neuroimaging results of surgical treatment of cervical spondylogenic myelopathy.
Material and methods:226 patients with degenerative cervical spinal stenosis, accompanied by myelopathic syndrome, operated (91 women and 135 men, average age 48.1 years). The severity of pain syndrome (VAS scores), proprioceptive sensitivity (M. Doita scale), self-service ability (Nurick scale) and recovery after surgery (JOA scale) were clinically evaluated. The stability of the cervical spine evaluated radiologically. According to neuroimaging data concluded that the severity of stenosis and myelopathy focus decreased.
Results: Early and long-term clinical, radiological, and neuroimaging results were evaluated. In the long-term period (12, 60 and 120 months after surgery), the cervical pain syndrome was 0-3 points according to VAS, initially 6 8 points. When evaluating the results on the JOA scale, proven that the effectiveness of the treatment of myelopathy directly depends on the history and timing of the surgical intervention. According to the Nurick scale, there is a tendency significantly improve the neurological status in patients with the middle stage of the disease, the neurological status of patients with more pronounced stages remains stable or improves, but this requires a longer time. There was an improvement in deep sensitivity on the M. Doita scale in patients with all stages of the disease.
Conclusion: Both methods of surgical treatment (laminoplasty and corporectomy) lead to good outcomes in the treatment of CSM. The effectiveness of surgical treatment of CSM directly depends on the duration of the anamnesis and the timing of decompression intervention. Recovery is better with mild, moderate and moderate clinical manifestations of CSM and with timely access to the surgeon.
Professor Artem Gushcha was appointed Chief Department of Neurosurgery Research Center of Neurology Russian Academy of Medical Sciences in October 2011. He received the title and serves as Professor Neurosurgery in Russian Academy of Sciences, Neurosurgery Chair since 2008. His clinical and research direction includes minimal invasive and endoscopic spinal neurosurgery, degenerative deformities. He has published in field of minimally invasive surgical approaches to compressed spinal cord, cervical myelopathy, endoscopic treatment of spine degeneration and flexible intrathecal endoscopy .Since 2014 till 2019 Professor Artem Gushcha – The President Russian Association of Spine Surgeons. Since 2019 – Vice President. Since 2021 Gushcha Artem is the Representative EUSSAB in EUROSPINE, Member of WFNS Spinal committee.