[Comparison study on therapeutic effects of anterior approach versus posterior approach in treating multilevel cervical disc herniation].
OBJECTIVE
To investigate the therapeutic effects of anterior approach set (AAS) versus posterior approach set (PAS) in treating multilevel cervical disc herniation of three or four segments.


METHODS
Fifty-six cases of multilevel cervical disc herniation were retrospectively studied. Thirty-seven cases underwent anterior approach, and discectomy, selectively partial corpectomy with bone grafting and plate fixing was performed (AAS group); 19 cases underwent posterior approach, and laminectomy with lateral cervical mass plate screw fixing was performed (PAS group).


RESULTS
The follow-up periods were 6 months to 4 years and 5 months, averaging 2 years and 10 months in AAS group and 1 year and 5 months to 5 years and 1 month, averaging 3 years and 8 months in PAS group. JOA functional assessment and sagittal diameter of dural sac were not statistically significant between two groups before operation (P>0.05) and were significantly larger in AAS group than in PAS group after operation (P<0.01). The improvement rate of AAS was significant higher than that of PAS (P<0.01). The number of complication in AAS were slight more than that in PAS.


CONCLUSIONS
AAS is obviously better than PAS in the therapeutic effects. The operation of anterior decompression with bone grafting and plate fixing is an indication of multilevel cervical disc herniation of three or four segments.
Jin
Zhengshuai
Z
Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu, 210029, PR China. Jingzhengshuai@medmail.com.cn
Zhang
Ning
N
Wu
Naiqing
N
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies