Costa Francesco, Anania Carla Daniela, Agrillo Umberto, Roberto Assietti, Claudio Bernucci, Simona Bistazzoni, Daniele Bongetta, Carlo Brembilla, Barbara Cappelletto, Ardico Cocciaro, Battista Costella Giovanni, Raffaele De Falco, Andrea De Rosa, Carlo Del Vecchio, Mauro Dobran, Vito Fiorenza, Diego Garbossa, Giancarlo Guizzardi, Corrado Iaccarino, Claudio Irace, Michele Incerti, Innocenzi Gualtiero, Alessandro Landi, Giancarlo Lastrucci, Giuseppe Maida, Ciro Mastrantuoni, Rosario Maugeri, Vincenzo Meglio, Nicola Montemurro, Pierpaolo Nina, Andrea Parlangeli, Giovanni Pinna, Federico Pretti Pier, Armando Rapanà, Alessandro Ricci, Rossella Rispoli, Stefano Romoli, Sbaffi Per Filippo, Teresa Somma, Enrico Tessitore, Matteo Vitali, Zerbi Alberto, Gianluigi Zona, Barbanera Andrea
Spine Surgery Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Nazionale Neurologico C. Besta, Milan, Italy.
Neurosurgical Department, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Neurospine. 2023 Jun;20(2):415-429. doi: 10.14245/ns.2244996.498. Epub 2023 Jun 30.
Cervical spondylotic myelopathy (CSM) is a progressively growing pathology to afford by a spinal surgeon due to the aging of the population, associated with better treatment management and the best diagnosis and treatment solutions are greatly discussed. Nowadays that scientific literature is progressively increasing to identify the gold standard in diagnosis and treatment can be very challenging. This is particularly evident in spinal surgery with many different indications not only in different countries but also in the same local reality. In this scenario, many neurosurgical societies works to identify some guideline or recommendations to help spinal surgeons in daily practice. Furthermore, in an era in which legal issues are increasingly present in clinical practice to have some indications globally accepted can be very useful. World Federation of Neurosurgical Societies (WFNS) few years ago starts this process creating a list of recommendations originating from a worldwide steering committee to respect all the local reality. The spinal section of Italian Neurosurgical Society decides to adopt the WFNS recommendations with some revision basing on Italian scenario. The steering committee of the Spinal Section of Italian Neurosurgical Society identify 7 groups to review the literature of the last 10 years about different topics on CSM and to analyses the WFNS recommendations to adapt it to the Italian daily practice. The statements were discussed and voted in 2 sessions to obtain the final version. A list of recommendations on natural course and clinical presentation; diagnostic tests; conservative and surgical treatment; anterior, posterior and combined surgical treatment; role of neurophysiological monitoring and follow-up and outcome was created with only few new or revised statements respect the ones of WFNS. The Spine Section of Italian Neurosurgical Society create a list of recommendations that represent the more contemporary treatment concepts for CSM as presented in the highest quality clinical literature and best clinical practices available on this subject.
脊髓型颈椎病（CSM）是一种因人口老龄化而逐渐增多的疾病，脊柱外科医生需对其进行治疗，同时相关的治疗管理以及最佳诊断和治疗方案也备受讨论。如今，随着科学文献的不断增加，要确定诊断和治疗的金标准极具挑战性。这在脊柱外科领域尤为明显，不仅在不同国家，即便在同一地区也存在许多不同的适应症。在这种情况下，许多神经外科学会致力于制定一些指南或建议，以帮助脊柱外科医生开展日常工作。此外，在临床实践中法律问题日益凸显的时代，拥有一些全球公认的适应症会非常有用。世界神经外科学会联合会（WFNS）几年前启动了这一进程，成立了一个全球指导委员会，制定了一系列建议，以尊重所有地区的实际情况。意大利神经外科学会脊柱分会决定根据意大利的实际情况对WFNS的建议进行一些修订后予以采纳。意大利神经外科学会脊柱分会指导委员会确定了7个小组，对过去10年中有关CSM不同主题的文献进行回顾，并分析WFNS的建议，以使其适用于意大利的日常实践。这些声明在两次会议上进行了讨论和投票，以获得最终版本。最终形成了一份关于自然病程和临床表现、诊断测试、保守和手术治疗、前路、后路及联合手术治疗、神经生理监测的作用以及随访和结果的建议清单，与WFNS的建议相比，仅有少数新的或修订的声明。意大利神经外科学会脊柱分会制定的这份建议清单代表了CSM领域最现代的治疗理念，这些理念来自关于该主题的高质量临床文献和最佳临床实践。
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