Recommendations of WFNS Spine Committee
Makaleler > Tam Makale · 2019
Yazarlar: Mehmet ZİLELİ
Neurospine, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Scopus, 2019, cilt 16, ss 383-385
DOI: 10.14245/ns.19int003
Özet
Recommendations of WFNS Spine CommitteeThis special issue of the Neurospine is dedicated to a very important subject "Cervical Spondylotic Myelopathy and OPLL." It is a privilege for me as the cochairman of the World Federation of Neurosurgical Societies (WFNS) Spine Committee to be a part of this special issue.We have had long standing efforts to prepare guidelines of different spinal disorders.Among those, we organized a consensus meeting in Nagpur, India in September, 2018.During the consensus meeting each speaker had the task to create questions for the topic, to review the manuscripts of the last 10 years, find answers to those questions and make statements of recommendation.At the end of each talk those statements were voted by the committee members using Delphi method, and approved statements were declared as recommendations of the WFNS Spine Committee.There were 17 talks and we conjugated them in 5 papers.You will find those papers summarizing the efforts of WFNS Spine Committee to create some recommendations on the hot topic cervical spondylotic myelopathy (CSM).Attempts to construct evidence-based guidelines for management of CSM are not new, nor will it be the last one.In 2009, the Joint Section on Disorders of the Spine and Peripheral Nerves of AANS (American Association of Neurological Surgeons) and CNS (Congress of Neurological Surgeons) has published their guidelines in the Journal of Neurosurgery Spine. 1 They called it "Guidelines for the Surgical Management of Cervical Degenerative Disease." In 2010, the North American Spine Society published their guidelines on "Diagnosis and Treatment of Cervical Radiculopathy from Degenerative Disorders, " 2 although it was dealing mostly with cervical disc herniation, not CSM.They published it in a 2011 issue of The Spine Journal. 3 In 2013, a group of authors supported by AOSpine North America have published some guidelines in the special issue "Surgical Treatment of Cervical Spondylotic Myelopathy" of Spine.4,5 In 2017 some members of this group headed by Michael Fehlings published their new guidelines with support of AOSpine and the CSRS (Cervical Spine Research Society).The publication of the guideline papers was in a special issue of the Global Spine Journal.6-10 This was a very detailed study and we as the WFNS Spine Committee have endorsed those guidelines with some minor changes.You can find those guidelines on our web site www.wfns-spine.org.The 5 papers you will find in the following pages are reviewing almost all aspects of the CSM: ( 1) Techniques for diagnosis and natural course.(2) Value of surgery and nonsurgical approaches for CSM.(3) Anterior surgical techniques for CSM.(4) Posterior surgical techniques for CSM.(5) Outcome measures and variables affecting prognosis of CSM.Clinical presentation of CSM and scores defining the severity of the disease is the subject of the first paper.Natural course of CSM was examined in 4 different groups: (a) moderate to severe CSM patients (modified Japanese Orthopedic Association scale [mJOA] scores