Recent progress in surgical treatment of cervical spine myelopathy – A narrative review

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-26 DOI:10.1016/j.jcot.2025.103074

Jun Ouchida, Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Shiro Imagama

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Abstract

Surgical techniques and technology for cervical spondylotic myelopathy (CSM) have demonstrated remarkable advancement during the past decade. This narrative review examines the evolution of surgical approaches and technological innovations, focusing on both anterior and posterior techniques. Anterior approaches have progressed through the development of endoscopic procedures, novel decompression methods such as vertebral body sliding osteotomy, and advanced implant materials including 3D-printed customized devices. Posterior approaches have evolved with the integration of endoscopic techniques and refined fixation methods, demonstrating reduced tissue trauma and improved outcomes. The integration of surgical assistance technologies, including navigation systems, robotics, and augmented reality, has enhanced surgical precision while potentially reducing procedural risks. While these advances show promising outcomes in terms of surgical precision and patient recovery, challenges persist regarding technology implementation and cost-effectiveness. Emerging technologies such as artificial intelligence for surgical planning, patient-specific implants, and adjunctive biological therapies may further improve CSM treatment. The optimal application of these innovations requires continued research and careful evaluation to establish their long-term efficacy and safety in clinical practice.

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颈椎病手术治疗的最新进展-综述

脊髓型颈椎病（CSM）的外科技术和技术在过去十年中取得了显著的进步。本文回顾了手术入路和技术创新的发展，重点是前路和后路技术。通过内窥镜手术、椎体滑动截骨等新型减压方法以及包括3d打印定制设备在内的先进植入材料的发展，前路入路取得了进展。后路手术随着内窥镜技术和精细固定方法的整合而发展，显示出减少组织创伤和改善的结果。手术辅助技术的整合，包括导航系统、机器人和增强现实，提高了手术精度，同时潜在地降低了手术风险。虽然这些进步在手术精度和患者康复方面显示出有希望的结果，但在技术实施和成本效益方面仍然存在挑战。人工智能手术计划、患者特异性植入物和辅助生物疗法等新兴技术可能会进一步改善脊髓炎的治疗。这些创新的最佳应用需要持续的研究和仔细的评估，以确定其在临床实践中的长期疗效和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.