[Alternatives of anterior and posterior approaches for cervical spondylotic myelopathy].
OBJECTIVE
To discuss on the effect of cervical spondylotic myelopathy before and after surgery and assess its indications and efficacy.


METHODS
From June 2002 to June 2006, 125 patients with cervical spondylotic myelopathy were analyzed retrospectively involving 58 anterior routine and 67 posterior routine, of which 71 cases of males, 54 cases of females, aged from 28 to 69 years (average 53.4 years). The course was 0.5 to 48 months (means 14 months). According to JOA score system preoperative and postoperative nerve function were analyzed, summarized anterior and posterior cervical spine surgery.


RESULTS
All patients were followed up for from 6 to 30 months (average of 18 months). According to JOA score criteria: anterior cervical surgery preoperative JOA score was (8.78 +/- 2.43) points, postoperative JOA score was (14.68 +/- 2.37) points, the results were excellent in 40 cases, good in 10 cases, effective in 6. Posterior surgical group preoperative JOA score was (8.49 +/- 2.58) points, postoperative JOA score was (14.26 +/- 2.83) points, the results were excellent in 42 cases, good in 12 cases, effective in 8. Invalid operation occurrenced in 6 cases included 2 of anterior, 4 of posterior. The postoperative symptoms had worsed in 1 case of posterior operation. The two groups had no statistical difference in efficacy, but there were differences statistically in the same approach comparing preoperative and postoperative.


CONCLUSIONS
Both anterior and posterior approaches have fine effect to the treatment of cervical spondylotic myelopathy (CSM). But the selection of the indication is very important, the patients with the pressure from anterior, the short-level changes, and the main symptoms of pyramid trac compression, adopt anterior approach on principle. While the patients with the pressure of spinal cord from posterior, multilevel changes, main symptoms of sensory disturbances, and accompanied by cervical spine canal stenosis mainly is introduced posterior approach.
Yang
Feng
F
Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China.
Tan
Ming-sheng
MS
Yi
Ping
P
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055009:Spondylosis / Q000503:physiopathology / Q000601:surgery*