Keith H. Bridwell,Paul A. Anderson,Scott D. Boden,Han Jo Kim

Alexander R. Vaccaro,Jeffrey C. Wang

Clinical spinal research has excelled in the past year, and the results will aid in decision making for our patients. A large observational trial and a series of systematic reviews on cervical myelopathy provide much-needed evidence regarding treatment decisions. The measurement and understanding of cervical spinal alignment as part of the overall spinal balance and its correlation to pain and neurologic dysfunction is being critically evaluated. Three new cervical artificial discs have been approved, and long-term outcomes of already approved devices show maintenance of good and excellent outcomes.

Cervical Myelopathy

Fehlings et al. reported on the one-year results of a multicenter observational study of 222 patients with cervical myelopathy. Significant improvement was seen in pain reduction, function, gait, and quality of life after surgery. Three patients had neurologic deterioration perioperatively, and two recovered to their baseline status. The outcomes with regard to anterior or posterior approach, after adjusting for baseline differences, showed no statistical differences. In a multivariate analysis, predictors of poor outcome were longer duration of symptoms, poorer baseline function, the presence of psychological comorbidities, severe gait disorder, and older age.