Rascón-Sosa OM, Robles-Ortiz RE, Rodríguez-Messina AF, Hernández-Cora A, Ramírez-Hernández F

Language: Spanish
References: 20
Page: 247-253
PDF size: 287.69 Kb.

ABSTRACT

Degenerative cervical myelopathy is a compressive pathology of the spinal cord caused by static and dynamic pathophysiological mechanisms that perpetuate spinal cord ischemia, it can be classified as mild, moderate and severe, requiring surgical management in the last two cases to release the spinal cord. The surgical decision of which approach to choose is difficult, since there is no clear consensus or follow-up guide that specifically indicates which procedure to choose. Carrying out a comprehensive evaluation of the patient with an imaging approach allows the spine surgeon to make the best decision in the process of patient recovery. The clinical case of a 60-year-old male patient with type 2 diabetes mellitus, systemic arterial hypertension and end-stage chronic kidney disease on hemodialysis who was admitted to our unit due to neurological deficit in upper and lower extremities integrating the diagnosis of degenerative cervical myelopathy is presented. A series of imaging studies were performed as well as analysis of the clinical characteristics of the patient, being a candidate for a posterior cervical-thoracic approach + C5-C7 laminectomy + C4 to T2 cervical-thoracic fixation with good functional results. The surgeon's decision on the surgical approach to perform for decompression of cervical spondylotic myelopathy must be accompanied by an analysis of the patient's physical characteristics, the findings on X-rays, computed tomography and magnetic resonance, and the conditions that accompany the patient to ensure a better functional prognosis and reduce the risk of post-surgical complications.

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