Recently, the surgical results for cervical spondylotic myelopathy are gradually improving, but in some cases multiple operations are required.
We have reviewed 45 patients who required multiple operations of the cervical spine. For the first operation, forty-three patients were treated by anterior interbody fusion by the Cloward's or Smith-Robinson's technique (AF) and 2 (athetoid CP) by extensive laminectomy (L). For the second operation, twenty-seven patients were treated by AF, 15 by L and 3 by enlargement of cervical spinal canal (E). Among them, we have carried out the third operation on seven patients (AF: 2, L: 2, E: 3).
The causes of multiple operations are recurrence at the other disc level, mischoice of surgical procedures, non-union, unexpected postoperative OPLL, failure of decion of surgical site and athetoid CP.
We must decide appropriate surgical procedures and surgical site for each patient, referring to the clinical symptoms, roentgenograms and myelography findings.