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Review
. 2023 Dec 8;7(12):e23.00027.
doi: 10.5435/JAAOSGlobal-D-23-00027. eCollection 2023 Dec 1.

Failure of Surgical Equipoise in Posterior Cord Syndrome Myelopathy

Drew A Bednar  1 , Mohamed Sarraj, Alina Rose Nanji
Affiliations
Review

Failure of Surgical Equipoise in Posterior Cord Syndrome Myelopathy

Drew A Bednar et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

We suggest that a clinical diagnosis of posterior cord syndrome indicates primary posterior decompression in cervical spondylotic myelopathy cases. We present two unique cases of failed anterior decompression in neutrally aligned necks with compressive myelopathy and a literature review. Two recent cases of cervical spondylotic myelopathy that failed to respond after anterior surgical decompression and fusion surgery were observed at our institution. Both patients had motor strength preservation but were unable to stand and walk independently and had other clinical findings consistent with posterior cord syndrome rather than the more common anterior or central cord syndromes, and both responded well to staged posterior decompression. Posterior cervical decompression successfully relieved posterior cord syndrome symptoms after a failed anterior decompression in both of our cases. Posterior cord syndrome is a rare syndrome best diagnosed clinically and should be considered in cases of cervical spondylotic myelopathy in which motor strength testing is preserved.

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Figures

Figure 1
Figure 1
Case 1; Preoperative MRI.
Figure 2
Figure 2
Case 1; MRI after primary anterior surgery.
Figure 3
Figure 3
Case 2; Preoperative MRI.
Figure 4
Figure 4
Case 2; MRI after primary anterior surgery
See this image and copyright information in PMC

References

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