Surgical Treatment Landscape for Cervical Spondylotic Myelopathy (Podcast)

Cervical spondylotic myelopathy is the most common cause of spinal cord impairment in adults over age 55. Its surgical treatment typically consists of one of three primary options: anterior disc replacement with fusion, laminectomy and fusion, and laminoplasty.

“We aim to tailor the type of surgery to the patient’s vocation and activity level, but the choice is also dictated in large part by the pathology and the spinal alignment,” says Thomas Mroz, MD, a spine surgeon in the Center for Spine Health at Cleveland Clinic.

In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Mroz guides non-spine surgeons through many of the considerations surrounding surgical treatment of cervical spondylotic myelopathy. He touches on the following topics, among others:

Symptoms, diagnosis and progression of cervical spondylotic myelopathy

When a recommendation for surgery is appropriate

• The essentials of each procedure option, and choosing among options
• Special considerations for patients with congenital cervical stenosis
• Post-surgery recovery
• The role of artificial intelligence in surgical decision-making for this condition

Click the podcast player above to listen to the 28-minute episode now, or read on for a brief edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

This activity has been approved for AMA PRA Category 1 Credit™ and ANCC contact hours. After listening to the podcast, you can claim your credit here.

Excerpt from the podcast

Podcast host Glen Stevens, DO, PhD: What’s new or emerging in the surgical treatment of cervical spondylotic myelopathy? Is there anything of particular interest on the horizon?

Thomas Mroz, MD: For the cervical spine, there are two things particularly worth watching. First, there are a couple of important studies being launched right now to determine the merits and limitations of laminoplasty versus laminectomy and fusion for treatment of cervical spondylotic myelopathy. Those will further explore issues examined in a recent randomized controlled trial showing that laminoplasty had benefit in terms of how patients perform on a number of secondary outcomes. Cleveland Clinic’s Michael Steinmetz, MD, and Edward Benzel, MD, were a part of that trial.

The other area where I think cervical spine surgery will evolve over the next 10 years is artificial intelligence. For instance, there are the two technologies I mentioned earlier that help surgeons preoperatively understand which patients are the best candidates for surgery and help guide the decision of which surgery to use for a particular patient. Patient-specific care is going to really advance in cervical spine surgery and in spine surgery more generally. It’s going to be an exciting decade ahead of us.