The role of distraction in improving the space available for the cord in cervical spondylosis

James C. Bayley, Jung Yoo, David M. Kruger, John Schlegel

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Study Design. This study analyzed the effects of distraction via strut graft insertion on the canal dimensions in spondylotic human cadaver cervical spines. Transverse and anteroposterior diameters and crosssectional areas were measured by transverse computed tomography imaging before and after distraction with out direct decompression. Objectives. This experiment was designed to address whether distraction across the disc space without direct canal decompression can improve the space available for the cord. Summary of Background Data. Smith-Robinson anterior discectomy and fusion have been shown to improve clinical symptoms of radiculopathy and myelopthy even in the absence of direct decompression. This has been postulated to be the result of gradual resorption of intruding osteophytes. However, the immediate effects of indirect distraction alone have not been previously investigated. Methods. Four cadaver spines from elderly donors were harvested intact. The transverse diameter, anteroposterior diameter, and cross-sectional area of the spinal canal were measured before and after discectomy and distraction via insertion of fibular strut graft by digitization of contiguous computed tomography scan slices. Results. The spinal canal dimensions before distraction were found to vary in a sinusoidal pattern around the disc space, with the maximum measurements located at the pedicle and the minimum measurements at the spondylotic ridge above or below the disc space. Distraction via strut graft insertion significantly increased the anteroposterior diameter and cross-section area, but had a negligible effect on transverse diameter. Conclusions. Anterior discectomy and distraction with a strut graft can significantly improve the space available for the cord in cervical spondylosis. Osteophyte debridement, which risks latrogenic injury to the cord may not always be necessary for improving clinical radiculopathy and myelopathy.

Original languageEnglish (US)
Pages (from-to)771-775
Number of pages5
JournalSpine
Volume20
Issue number7
StatePublished - 1995
Externally publishedYes

Fingerprint

Spondylosis
Diskectomy
Decompression
Transplants
Osteophyte
Radiculopathy
Spinal Canal
Cadaver
Spine
Tomography
Spinal Cord Diseases
Debridement
Tissue Donors
Wounds and Injuries

Keywords

  • Cervical spine
  • Distraction
  • Myelopathy
  • Spondylosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine
  • Physiology

Cite this

Bayley, J. C., Yoo, J., Kruger, D. M., & Schlegel, J. (1995). The role of distraction in improving the space available for the cord in cervical spondylosis. Spine, 20(7), 771-775.

The role of distraction in improving the space available for the cord in cervical spondylosis. / Bayley, James C.; Yoo, Jung; Kruger, David M.; Schlegel, John.

In: Spine, Vol. 20, No. 7, 1995, p. 771-775.

Research output: Contribution to journalArticle

Bayley, JC, Yoo, J, Kruger, DM & Schlegel, J 1995, 'The role of distraction in improving the space available for the cord in cervical spondylosis', Spine, vol. 20, no. 7, pp. 771-775.
Bayley, James C. ; Yoo, Jung ; Kruger, David M. ; Schlegel, John. / The role of distraction in improving the space available for the cord in cervical spondylosis. In: Spine. 1995 ; Vol. 20, No. 7. pp. 771-775.
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