Professional and Linguistic Assessments Board (PLAB) Practice Exam

What surgical intervention is primarily indicated for cervical myelopathy?

1. Discectomy

2. Decompression surgery

3. Fusion surgery

4. Laminectomy

The correct answer is: Decompression surgery

Cervical myelopathy occurs when there is compression of the spinal cord in the cervical region, often due to degenerative changes, herniated discs, or spinal stenosis. The primary goal of surgical intervention in cases of cervical myelopathy is to relieve this pressure on the spinal cord, thereby improving neurological function and preventing further deterioration. Decompression surgery, which includes techniques such as laminectomy or anterior cervical discectomy, directly addresses the cause of myelopathy by creating more space around the affected areas of the spinal cord. This removal or adjustment of bone, disc material, or tissue alleviates the compression, hence the name 'decompression surgery.' It is most effective when timely intervention is undertaken to maximize the chances of neurological recovery. While other procedures like discectomy, fusion surgery, or laminectomy can be part of the surgical approach, they do not solely target the primary indication for treating cervical myelopathy. For example, while discectomy involves the removal of herniated disc material, it may not address other forms of compression. Similarly, fusion surgery stabilizes the cervical spine post-decompression but is not solely indicated for myelopathy without the decompression step. Therefore, decompression surgery stands out