Failure of Surgical Equipoise in Posterior Cord Syndrome Myelopathy

The study suggests that if a patient is diagnosed with posterior cord syndrome, the initial surgical approach should be posterior decompression, especially in cases of cervical spondylotic myelopathy. Two cases are presented where anterior decompression surgery failed to alleviate symptoms of posterior cord syndrome, but subsequent posterior decompression provided significant relief. Posterior cord syndrome is a rare condition that is best diagnosed through clinical evaluation. It should be considered in patients with cervical spondylotic myelopathy who maintain motor strength.

• 1
  Anterior cervical decompression may not relieve posterior cord compression in patients with cervical spondylotic myelopathy.
• 2
  Posterior cervical decompression can successfully relieve posterior cord syndrome symptoms after a failed anterior decompression.
• 3
  Preserved motor strength in patients with cervical spondylotic myelopathy should raise suspicion for posterior cord syndrome.