HCM City (VNS/VNA) -A minimally invasive technique called Tateru Shiraishi cervical laminoplasty isthe best choice for treating patients with cervical myelopathy as it reducesthe need for long postoperative care, according to doctors.
Cervical myelopathy is caused bya narrowing of the spinal canal, leading to cord dysfunction.
Laminoplasty is a surgicalprocedure that creates more space for the spinal cord and nerve roots torelieve abnormal pressure on the spinal cord, according to the Virginia SpineInstitute in the US.
Dr Vo Van Thanh, a consultant forHCM City’s Trung Vuong Hospital, said that cervical myelopathy is more frequentin Asia Pacific, including Vietnam, than in other areas of the world.
However, as advanced diagnosistechniques such as MRIs are now available in the country, the number ofpatients with cervical myelopathy has increased because of early detection, Thanhsaid.
Recently, the Trung VuongHospital admitted a 76-year-old man from HCM City with cervical myelopathy causedby cervical stenosis and spondylosis. Degenerative changes due to ageingnarrowed the neck’s protective spinal canal, leading to cervical spinalstenosis.
For at least a year, the man hadweakness in the muscles of his arms, leading to problems in grasping andholding items. He also had coordination problems, which affected his walking.
He has lost fine motor skills,leading to difficulty with handwriting, buttoning his clothes, and feedinghimself.
Dr Ho Nhut Tam, head of thehospital’s spinal unit, said that surgery should be performed but there wouldbe risks because the patient suffers from hypertension, diabetes, gout andchronic kidney failure. The patient currently receives dialysis.
If the surgery is not performed,the spinal cord could become more compressed and paralysis could occur, Tamsaid.
After consultation with Dr Thanh,doctors decided to use the Tateru Shiraishi cervical laminoplasty to limitrisks, he added. The hospital’s doctors worked with Dr Vo Ngoc Thien An fromthe Hospital for Traumatology and Orthopaedics toconduct the operation 13 days ago.
The patient’s motor skillsimproved three to four days after surgery. Heis expected to completely recover after three months of physical therapy, Tamsaid.
Dr An said that doctors whoperform this technique must be well-trained and have practice as it requireshigh precision. The aim is to prevent postoperative complications such asdamage of blood vessels that connect to the spinal cord.
Cervical myelopathy tends to getworse slowly over time, An said.
Dr Thanh said that if patientsare diagnosed in time, the success of surgery is high.
Dr An said that symptoms includenumbness in one or two arms from the shoulder to the hand.
In Vietnam, research on cervicalmyelopathy has been limited, An said, adding that in Japan, studies showed thatit was more common among men than women because of certain jobs that affectedcord dysfunction. The average age of patients affected is 40-60 years old.-VNA