Laminectomy and Fusion for Cervical Spondylotic Myelopathy
Cervical spondylotic myelopathy accounts for the majority of cases of spinal cord dysfunction in older adults. This common cause of neck pain results from degenerative changes in the cervical spine, including age-related damage to the joints, discs, ligaments, and connective tissue in the neck, that results in spinal cord compression. The treatment for this condition will depend on the extent of the degeneration and symptoms but typically involves laminectomy and spinal fusion.
Symptoms of cervical spondylotic myelopathy usually develop gradually and may be confused for other conditions, such as multiple sclerosis, amyotrophic lateral sclerosis and even spine tumours. Symptoms may include:
- Neck stiffness
- Arm pain
- Numbness in the hands
- Weakness in the hands and legs
- Neck pain
Diagnosing Cervical Spondlyotic Myelopathy
Patients are usually diagnosed on the basis of magnetic resonance imaging that shows spinal stenosis caused by the growth of bone spurs, disc herniation, and/or overgrowth of the ligamentum flavum. These degenerative changes can result in spinal cord compression when the person is at rest (i.e. static mechanical), compression when in motion (dynamic mechanical), or spinal cord ischaemia (where blood flow is cut off to areas of the spine).
Treatment choice often involves a decision to undergo back surgery to decompress the spinal cord, as well as, in some cases, to fuse the spine to restore stability. One surgical option is a laminectomy with spinal fusion, a type of surgery that removes part of the stiff ligament at the back of the spine in order to allow the interior structures more space and thereby reduce cord compression.
How Safe and Effective is Laminectomy and Fusion for Neck Pain?
In one recent retrospective study, 58 patients who underwent cervical laminectomy and fusion for cervical spondylotic myelopathy had a statistically significant improvement between their score on the modified Japanese Orthopedic Association scale (mJOA) before surgery and after surgery. The average pre-operative score was 13.2 and postoperative was 16.1, with an average improvement of 2.9 points.
In this study 85.5% of patients improved with neck surgery, and the remainder had no change in their mJOA score. The patients’ average neurological recovery rate was 56.6% but there was a 10.3% overall complication rate. The most common complication after laminectomy and fusion was nerve palsy at C5, which occurred in some 6.9% of patients. These nerve palsies completely resolved, leading the authors to conclude that cervical laminectomy and fusion is a safe and effective procedure to treat cervical spondylotic myelopathy.
Changes in the cervical spine that put pressure on the nerves and spinal cord can lead to irreversible damage, chronic pain, weakness, paralysis and even death. Anyone who suspects that they have cervical spondylotic myelopathy should consult their physician for a thorough assessment as early intervention can help prevent further damage and reduce the risk of serious complications if the condition is left untreated.
Reference
Chang V, Lu DC, Hoffman H, Buchanan C, Holly LT. Clinical results of cervical laminectomy and fusion for the treatment of cervical spondylotic myelopathy in 58 consecutive patients. Surg Neurol Int. 2014 Apr 16;5(Suppl 3):S133-7. doi: 10.4103/2152-7806.130670. eCollection 2014.
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COSC Certification and its Demanding Standards
COSC, or the Controle Officiel Suisse des Chronometres, is the official Switzerland testing agency that verifies the accuracy and accuracy of wristwatches. COSC certification is a sign of excellent craftsmanship and trustworthiness in timekeeping. Not all timepiece brands seek COSC certification, such as Hublot, which instead sticks to its own strict criteria with movements like the UNICO calibre, reaching similar accuracy.
The Science of Exact Timekeeping
The central system of a mechanical timepiece involves the spring, which provides power as it loosens. This mechanism, however, can be prone to external factors that may affect its accuracy. COSC-validated mechanisms undergo demanding testing—over 15 days in various conditions (five positions, three temperatures)—to ensure their resilience and reliability. The tests assess:
Typical daily rate precision between -4 and +6 seconds.
Mean variation, highest variation levels, and effects of temperature variations.
Why COSC Accreditation Matters
For watch aficionados and collectors, a COSC-validated watch isn’t just a piece of tech but a testament to lasting excellence and precision. It symbolizes a timepiece that:
Presents excellent reliability and accuracy.
Ensures confidence of superiority across the complete construction of the timepiece.
Is probable to maintain its value more efficiently, making it a smart choice.
Famous Chronometer Brands
Several famous manufacturers prioritize COSC accreditation for their watches, including Rolex, Omega, Breitling, and Longines, among others. Longines, for instance, presents collections like the Archive and Soul, which highlight COSC-accredited movements equipped with innovative substances like silicon balance springs to boost resilience and performance.
Historic Background and the Development of Timepieces
The notion of the timepiece originates back to the need for precise chronometry for navigation at sea, highlighted by John Harrison’s work in the 18th cent. Since the formal establishment of COSC in 1973, the certification has become a yardstick for assessing the precision of high-end watches, maintaining a legacy of superiority in horology.
Conclusion
Owning a COSC-certified timepiece is more than an visual selection; it’s a commitment to quality and accuracy. For those valuing precision above all, the COSC accreditation offers peace of thoughts, ensuring that each validated watch will operate dependably under various circumstances. Whether for personal satisfaction or as an investment, COSC-accredited watches stand out in the world of horology, maintaining on a tradition of careful chronometry.
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