title: Four-level cervical corpectomy.
abstract: METHODS
  Retrospective analysis of 31 cases of cervical spondylotic myelopathy treated by four-level subaxial cervical corpectomy.
  
  
  OBJECTIVE
  To determine whether extremes of anterior decompression and fusion have inordinate or unique levels of morbidity.
  
  
  BACKGROUND
  There is a paucity of data on experience with four-level corpectomy. However, counsel against such surgery can be found.
  
  
  METHODS
  The records and studies of 31 consecutive cases of cervical spondylotic myelopathy, treated by four-level corpectomy, were retrospectively analyzed. Patients in 26 cases were observed longer than 2 years. No hardware was used in the procedures. External orthosis, worn for 6 months, was a Philadelphia-type collar in 25 patients and a halo vest in 6.
  
  
  RESULTS
  Three patients died within 3 weeks of surgery (9.7%). Delayed radiculopathy occurred in four patients after surgery, three had acute graft complications, and one had pseudomeningocele, for a morbidity rate of 25.8%. There was no infection or worsened myelopathy.
  
  
  CONCLUSIONS
  No unique morbidity is associated with extremes of subaxial decompression when compared with surgery of lesser extent.
authors.affiliation: Section of Neurological Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Saunders
authors.forename: H J
authors.initials: HJ
authors.lastname: Pikus
authors.forename: P
authors.initials: P
authors.lastname: Ball
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013117:Spinal Cord Compression / Q000209:etiology / Q000517:prevention & control; D013123:Spinal Fusion / Q000379:methods*; D013128:Spinal Osteophytosis / Q000150:complications / Q000601:surgery*; D013997:Time Factors