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Patients have similar benefits after anterior, posterior approach for cervical spondylotic myelopathy
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Patients who underwent either anterior cervical discectomy and fusion combined with segmental corpectomy or posterior laminectomy and fusion for treatment of four-level cervical spondylotic myelopathy showed improved outcomes. However, researchers in this study noted specific benefits for patients depending on the procedure used.
“Anterior cervical discectomy and fusion combined with segmental corpectomy can directly relieve compression, provide an additional screw purchase and strengthen the construct, and allow substantial restoration of cervical lordosis,” Dasheng Lin, MD, and colleagues wrote in their study. “Despite its limitations with regard to cervical curvature, posterior fixation can achieve effective decompression and maintain or restore stability of the cervical spine using multilevel laminectomy, thereby improving symptoms of spinal cord compression, especially for patients with cervical lordosis.”
Lin and colleagues evaluated 51 patients with four-level cervical spondylotic myelopathy who underwent either anterior cervical discectomy and fusion (ACDF) combined with segmental corpectomy or posterior laminectomy and fusion, according to the abstract.
There were no significant differences in mean range of motion in either group. The ACDF and segmental corpectomy group had improved Japanese Orthopaedic Association (JOA) scores from 9.6 points preoperatively to 13.9 points postoperatively, while the Nurick grade scores in this group also improved, from 2.74 points preoperatively to 0.86 points postoperatively. The posterior laminectomy and fusion group had improved JOA scores from 9.4 points preoperatively to 13.1 points postoperatively and the Nurick grade scores improved from 2.81 points preoperatively to 1.32 points postoperatively.
In patients with cervical kyphosis, the researchers noted no significant differences in preoperative JOA or Nurick scores in either group. However, the ACDF with segmental corpectomy group had improved scores after surgery, according to the abstract.
Disclosure: The authors have no relevant financial disclosures.
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