Chronic spondylogenic cervical myelopathy. A critical evaluation of surgical treatment after early and long-term follow-up.

In the past, chronic spondylogenic cervical myelopathy has been thought of being a disease often resistant to neurosurgical therapy. 56 out of 70 patient treated by laminectomy or different ventral fusion procedures improved immediately following operation. Only 36, however, continued to be improved at follow-up 5 to 8 years later, whereas additional 8 had worsened again, and another 5 mean-while had died due to myelopathy. Laminectomy turned out to be the least successful procedure of treatment. Nevertheless, early diagnosis, early operation, appropriate and individual surgical procedures, careful re-evaluation at follow-up, and -- if needed -- an early decision for a second-step operation can impressively improve the prognosis.