New GSJ Focus Issue is out: Motion Preserving Surgery for Degenerative Cervical Myelopathy

Open door posterior cervical laminoplasty. An important motion preserving surgical option for the management of DCM. Reproduced With Permission From Grochulla F., Laminoplasty. In: Vieweg U and Grochulla F. Editors. Manual of Spine Surgery. Second Edition. Springer-Verlag GmbH Germany 2023.

The Global Spine Journal (GSJ) is proud to announce the publication of a new Focus Issue, representing a collaboration between AO North America (AO NA) and the AO Spine Knowledge Forum Spinal Cord Injury (KF SCI). This special edition, titled “Motion Preserving Surgery for Degenerative Cervical Myelopathy: Where Are We Now?”, brings together leading experts to address one of the most prevalent and challenging conditions in spine surgery: Degenerative Cervical Myelopathy (DCM).

Check out the Focus Issue now

Read the quick summary
Rising DCM incidence demands innovative surgical solutions beyond traditional fusion methods.

Motion-preserving surgery aims to restore neurological function while minimizing complications associated with fusion.

The new focus issue features six comprehensive papers reviewing current evidence and future directions for motion-preserving surgeries in DCM.

It exemplifies a successful collaborative effort between an AO regional entity and global research.

DCM is a complex, age-related disease affecting the cervical spine, commonly encountered by spine surgeons worldwide. It arises from various pathologies such as spondylosis, osteophytosis, disc degeneration, and hypertrophy or ossification of soft tissues. These changes can injure the cervical cord through both static mechanisms like canal stenosis and chronic compression and dynamic mechanisms such as instability and repeated trauma during spinal motion.

Principal Investigator and KF SCI Steering Committee member Jeff Wilson highlighted the importance of the new focus issue for spine surgeons and practitioners and the apparent benefits of motion-preserving surgery: “Motion-preserving surgery is an important treatment option in the management of certain patients with cervical myelopathy, aiming to restore neurological function while minimizing the short- and long-term issues associated with spinal fusion. This Focus Issue critically examines the current evidence, emerging techniques and translational implications of this evolving field.”

Endoscopic laminectomy pushing new boundaries for minimally invasive surgery for degenerative cervical myelopathy. All Images Were Provided by Dr Ji Soo Ha.

Unilateral Biportal Endoscopic Cervical Discectomy. Preoperative (A) and Postoperative Magnetic Resonance Images (B). Operative View Before the Discectomy, (C) During the Discectomy (D), and After the Discectomy (E). All Images Were Provided by Dr Ji Soo Ha.

Unilateral Biportal Endoscopic Cervical Foraminotomy and Decompression. Preoperative Magnetic Resonance Images (A). Operative View of the Flavum (B) and V-Point (C) During the Foraminotomy at the C6-C7 Level. Operative View of the Nerve Root After Decompression (D). All Images Were Provided by Dr Ji Soo Ha.

Rising incidence of DCM calls for new solutions

With improved diagnostic access and an aging population, the incidence of DCM is expected to rise, underscoring the need for innovative treatment solutions.

Historically, surgical decompression and instrumented fusion have been the mainstay treatments, aiming to counteract dynamic injury mechanisms. However, these approaches can lead to adjacent segment degeneration and reduced cervical spine mobility, impacting patients’ quality of life.

Recent interest has shifted toward motion-preserving surgical techniques, including cervical disc arthroplasty (CDA), endoscopic cervical spine surgery, laminectomy without fusion, and laminoplasty. Yet, evidence and best practices for these techniques in the context of DCM remain underexplored.

Guest editor and Chairperson of KF SCI Shekar Kurpad sees the future of DCM patient care rely on personalized treatment solutions: “The future of personalized medicine as it relates to spine surgery will rely heavily on a deep understanding on mechanisms to preserve motion.”

Post-operative CT scan and cervical radiographs after posterior cervical laminoplasty, an important and effective treatment for DCM.

What topics does the new focus issue cover?

Kurpad highlighted the importance of a collaborative approach in spine research: “This Focus Issue represents a key effort that showcases the collaboration of AO Spine Knowledge Forum Spinal Cord Injury with a regional AO Section to bring together proven expertise in this topic.”

The result is a special focus issue featuring six comprehensive papers that review and synthesize the latest evidence on motion-preserving surgery for DCM:

Editorial: AO Spine NA / KF SCI Focus Issue Motion Preserving Surgery for Degenerative Cervical Myelopathy: Where Are We Now?
By Husain Shakil, Shekar Kurpad, Jefferson R Wilson
Cervical Disc Arthroplasty for the Treatment of Degenerative Cervical Myelopathy: What’s the Evidence?
By Anson Bautista, Ivan Z. Liu, Ankit Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Paula Valerie ter Wengel ter Wengel, Daipayan Guha, Vafa Rahimi-Movaghar, Ryan Quisling, Jonathan Palmer, Keith Jackson, John DeVine, Jefferson R. Wilson, Uzondu F Agochukwu
Clinical Outcomes and Future Directions of Endoscopic Cervical Spine Surgery: A Systematic Review with Narrative Insights
By Ryan Wang, Satheeshram Tamilselvan, Ji Soo Ha, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Uzondu F Agochukwu, Konstantinos Margetis, Yoon Ha, Michael Fehlings, Jefferson R Wilson, Ankit Mehta
Cervical Laminectomy for degenerative cervical myelopathy: Is there a role in the modern day? A systematic review and meta-analysis
By Christopher Lozano, Armaan K Malholtra, Husain Shakil, Vishwathsen Karthikeyan, Neevya Balasubramaniam, Uzondu F Agochukwu, Ankit Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Aminul I Ahmed, Ricardo Rodrigues Pinto, James Harrop, Michael Fehlings, Shekar Kurpad, Jefferson R Wilson
Laminoplasty versus Laminectomy and Fusion in the Treatment of Degenerative Cervical Myelopathy: A Systematic Review and Meta Analysis of Cost and Patient Centered Outcomes in the United States
By Vishwathsen Karthikeyan, Husain Shakil, Christopher Lozano, Armaan K Malholtra, Uzondu F Agochukwu, Ankit Mehta, C. Rory Goodwin, Nathan Evaniew, Paul Aarne Koljonen, Allan R. Martin, James David Guest, Shekar Kurpad, Jefferson R. Wilson, Aditya Vedantam
Techniques for Cervical Laminoplasty
By Newton Cho, Ankit Mehta, Aditya Vedantam, C. Rory Goodwin, Uzondu F Agochukwu, Lukas Grassner, Aria Nouri, Bizhan Aarabi, Jefferson R Wilson, Nathan Evaniew
Are Skip Laminectomy and Oblique Corpectomy Effective Options to Treat Degenerative Cervical Myelopathy while Preserving Motion? Results of a Scoping Review
By Justin Lomax, Ankit Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Mario Ganau, Chris J Neal, Rex Alexander Wong Marco, Ryan Quisling, Jonathan Palmer, Adam T Archie, Keith Jackson, John DeVine, Jefferson R Wilson, Uzondu F Agochukw

New GSJ Focus Issue: Motion Preserving Surgery for Degenerative Cervical Myelopathy

GSJ Focus Issues are valuable resources for spine practitioners

This latest focus issue serves as a vital reference for spine surgeons and practitioners, clarifying the evidence supporting motion preservation in DCM treatment and guiding clinical decision-making for this increasingly common condition.

For more information and to access the full Focus Issue, visit the Global Spine Journal website.

All GSJ Focus Issues are indexed in the special collection Global Spine Journal—Focus Issues. Most recently, the AO Spine Knowledge Forums produced the following focus issues:

Motion Preserving Surgery for Degenerative Cervical Myelopathy: Where Are We Now?
Adult Spinal Deformity: Understanding Controversies and Looking to the Future
Precision Medicine in Spinal Oncology
AO Spine and Praxis Spinal Cord Institute Guidelines for the Management of Acute Spinal Cord Injury
AO Spine Guideline for the Use of Osteobiologics (AOGO) in Anterior Cervical Discectomy and Fusion for Spinal Degenerative Cases developed by AO Spine Knowledge Forum Degenerative
What Motivates Treatment Decisions in Neurologically Intact Thoracolumbar Burst Fractures?