Why Haven’t Symptoms Improved After Successful Cervical Endoscopic Surgery? Cause of Postoperative Worsening Identified [Health Check]

[Financial News] Multilevel cervical myelopathy is a condition in which the spinal cord is compressed at multiple levels of the cervical spine, causing symptoms such as numbness in the hands and feet, difficulty walking, and reduced muscle strength. A study has found that the range of decompression may be a key factor when symptoms persist or worsen after endoscopic surgery for the condition.
Kim Ji-yeon, director of the Spine Center at Seran General Hospital (pictured), analyzed factors associated with neurological deterioration after biportal endoscopic posterior decompression in patients with multilevel cervical myelopathy. The analysis showed that the difference between the range of lesions with actual spinal cord compression and the range decompressed during surgery was associated with worsening postoperative symptoms. The researchers proposed the concept of “Structural Mismatch” to describe this relationship.
Because multilevel cervical myelopathy involves lesions across multiple areas, symptoms may persist or worsen if the decompressed area is insufficient compared with the extent of the lesions. It is therefore important to identify the location and extent of the lesions and select a surgical method capable of providing decompression across the necessary range.
As a way to address the limitations of endoscopic decompression, Kim proposed endoscopic laminoplasty. This technique preserves the lamina while providing decompression across the necessary range, allowing surgeons to consider both adequate decompression and preservation of spinal structures in cases of multilevel cervical myelopathy.
Kim developed the world’s first cervical laminoplasty using biportal spinal endoscopy and has performed more than 150 such surgeries to date.
“For multilevel cervical myelopathy, it is important to provide sufficient decompression across the necessary range while considering the extent of the lesions and the spinal structures,” Kim said. “This study confirmed that the difference between the actual lesion range and the decompressed range may be associated with worsening symptoms after surgery.”
The paper, titled “Risk Factors for Persistent Neurological Deterioration After Biportal Endoscopic Posterior Decompression for Multilevel Cervical Myelopathy: The Concept of Structural Mismatch,” was published in the July issue of the Journal of Minimally Invasive Spine Surgery & Technique (JMISST), an international journal in the field of minimally invasive spine surgery.
 


[email protected] Medical Specialist Reporter Jung Myung-jin Reporter