The surgical management of cervical myelopathy—A perspective from Asia pacific

Abstract

The cervical myelopathy is currently more frequent in Asia Pacific including Vietnam. The diagnosis is based mainly on clinical examination combined with scrutiny investigation for the detection of different compressive etiologies. The surgical management for serious compressive cervical myelopathy is often realized with rigorous indication in practicing different techniques adapting to the current situation of the patients and multi-various factor. The cervical laminoplasty was recognized and realized safely by laminoplasty for multiple level, with little or without cervical kyphosis. The alternative technique modified Hirabayashi laminoplasty with wiring from tips of spinous processes to the lateral mass screws has been practiced in Vietnam since 2003. The Tateru Shiraishi cervical laminoplsty with preservation of deep extensors and rotators-posterior cervical complex have been practiced since 2002 in showing the least muscular destruction and fibrous degeneration. It also improves the axial pain frequently seen with the classical Kurokawa or Itoh technique, currently applied in Japan.