What is the role of surgery in the treatment of focal muscular atrophy (FMA)?

Updated: Feb 20, 2018
  • Author: Sridharan Ramaratnam, MD, MBBS; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Surgery has no role in FMA, except in rare instances in which FMA is secondary to a surgically treatable intraspinal or extraspinal lesion.

A randomized trial of 2 surgical techniques, namely anterior cervical discectomy decompression with autologous iliac crest bone grafting and internal plate fixation (DDF) or anterior cervical corpectomy, posterior longitudinal ligament resection, autologous iliac crest bone grafting, and internal plate fixation (CDF), for patients with monomelic amyotrophy followed up for 2 years revealed subjective and electrophysiological improvement in 60-65% of patients. Because of the benign nature of the illness, cervical collar treatment is the preferred treatment, while surgery could be an exceptional second-line alternative. If surgery is chosen, DDF carries lower procedural risk compared with CDF. [66]


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