[A comparative research of multilevel cervical spondylotic myelopathy treated by two different anterior operative methods].
OBJECTIVE
To compare the outcomes of two operative methods, the anterior decompression in subsection and the anterior decompression in one section, which were used to treat multilevel cervical spondylotic myelopathy (CSM).


METHODS
Data of multilevel CSM undergoing the anterior decompression in subsection (33 cases, the subsection group) and the anterior decompression in one section (19 cases, the one section group) from July 1999 to January 2004 were retrospectively analyzed. The incidence of perioperative complications and the rate of fusion were evaluated by the postoperative X-ray and MRI examinations, and improvement of the neurological function was evaluated by the JOA score.


RESULTS
The incidence of perioperative complications was 36.8% in the one section group, mainly including immigration of the plate and grafts, which was settled by the revision surgery; while the incidence of perioperative compilcations was 12.1% in the subsection group, mainly including the immigration of the titanium mesh. There was a significant difference between the two groups (P < 0.05). 84.2% of the patients in the one section group and 81.8% of the patients in the subsection group developed bony fusion by the end of the follow-up (9-31 mon, averaged 11.2 mon), and there was no significant difference between the two groups (P > 0.05). According to the JOA score, the ratio of the improvement in the neurological function was 70.4% in the subsection group and 64.4% in the one section group. There was no significant difference between the two groups (P > 0.05).


CONCLUSIONS
The anterior decompression in subsection is more rational for the surgical treatment on the multilevel CSM than the anterior decompression in one section. It can provide an equal decompressive effect but a more stable local mechanical environment right after the surgery and can maintain it well, which is critical for the bony fusion.
Liu
Peng
P
Department of Orthopaedics, Daping Hospital and Institute of Field Surgery, Third Military Medical University, Chongqing, 400042, PR China.
Zhao
Jianhua
J
Li
Qihong
Q