Techniques for Improving Anterior

4/13/2024 1 Techniques for Improving Anterior Cervical Outcomes Matthew R. Moore, M.D. [...] 1 24/13/2024 2 Objectives 3 • Understand current review of surgical decision making for cervical myelopathy • Optimization and pearls for anterior approaches • Compare MNI recommendations using patient case (exit quiz) 3 44/13/2024 3 ANTERIOR versus POSTERIOR • Symptoms and Exam • Root……>………mixed………<……. [...] Cord • (motor/sensory/pain) • Anatomy • MRI/ CT scan / X-rays • (location/lordosis/levels) ADDITIONAL DECISION FACTORS • Medical risks/morbidities of Anterior v. [...] Discussion ……TEST to follow 25 264/13/2024 14 Patient Case Review • 82 yo female with 2 years of neck pain, left arm pain(C6) weakness and bilateral hand numbness loss of dexterity. [...] • Lower ext motor 5/5 • Hyper-reflexic U & L ext Tried PT, anti-inflamtories and ESI • PMH: asthma, osteoporosis, anxiety, FMD of upper carotids Xray; Fl / Ext no movement 27 284/13/2024 15 FACTORS for ANTERIOR vs. POSTERIOR • Compressed anatomy (central…….foraminal…….posterior) ? [...] • Lordosis/instability ? [...] • Axial neck pain severity ? [...] • Radicular arm pain severity ? [...] • Anterior two or three levels ? • Posterior ? [...] • Posterior levels ? SUMMARY/GOALS: • Understand consensus review of anterior v.