Researchers Seek to Understand Best Treatment Alternatives for Cervical Spondylotic Myelopathy

Aug. 23, 2011

Dr. Hani Malone

Resident Dr. Hani Malone and Dr. Michael Kaiser from the Spine Center are currently conducting clinical research to determine the optimal treatment strategies for patients presenting with cervical spondylotic myelopathy (CSM), a degenerative process of the neck that can lead to neurological deficits and impaired quality of life.

Dr. Kaiser is currently chairman of the Guidelines Committee for the AANS/CNS Joint Section of Spine and Peripheral Nerve Disorders, the function of which is to establish standardized treatment paradigms for various spinal disorders based on the best available medical evidence.

Dr. Hani Malone is one the rising stars in the Columbia University neurosurgical residency program, who had developed a strong interest in spine surgery and promises to be a future leader in this field.

CSM is the most common cause of myelopathy (injury to the spinal cord) in adults older than 55 years, often causing progressive disability and compromising the patient’s quality of life. Patients will often present with hand numbness, loss of dexterity, gait instability, and compromised urinary control.

The goal of surgery for CSM is to relieve pressure on the spinal cord and prevent further injury, while maintaining spinal stability.  Surgeons have developed a number of different approaches to treat CSM, but the optimal surgical approach for a given patient remains an area of debate.

In order to establish the best treatment alternatives, Drs. Malone and Kaiser have been reviewing the clinical experience of the Columbia University spine surgeons over the past 8 years, where over 500 patients with CSM have been treated.

Development of a prospective patient database has become a national initiative, with the hope that such data will define specific patient characteristics that can be used to determine the optimal surgical approach.

This is particularly true with CSM since there are a number of surgical alternatives that may be considered. In addition to stabilizing and improving neurological function, maintaining and/or restoring the optimal spinal configuration is a major surgical objective to minimize chronic pain, prevent progressive deformities, and maximize quality of life.

Dr. Michael Kaiser

This research is ongoing and Drs. Malone and Kaiser will be submitting the preliminary work presentation at upcoming national neurosurgical meetings, including the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves and the AANS Annual Meeting.

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