Causes of Neurologic Deterioration Following Surgical Treatment of Cervical Myelopathy

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Abstract
Neurologic deterioration was analyzed in 110 patients with surgically treated cervical myelopathy secondary to soft disc hernia or spondylosis. Follow-up periods ranged from 2 to 14 years with an average of 6 years. Of 110 patients, 29 suffered neurologic deterioration. In most of the patients, deterioration occurred within the first year after surgery. Causes of deterioration were divided into three categories; 1) direct trauma to neutral tissue during surgery (a preventable complication); 2) instability of the spine, progression of spondylotic changes above or below the level of fusion, and non-union (apparently unpreventable but treatable); and 3) nonsurgery-related accidental trauma (unavoidable and often irreversible). Countermeasures for the deterioration are discussed.

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