title: Single- and multi-level anterior decompression and fusion for cervical spondylotic myelopathy--a long term follow-up with a minimum of 5 years.
abstract: OBJECTIVE
  Cervical spondylotic myelopathy (CSM) is a common disease leading to significant neurological disability. We compared patients suffering from a single- and a multi-level pathology to analyze the influence of the natural course of the disease on the long-term outcome after surgery.
  
  
  METHODS
  We analyzed the records of 52 patients with CSM after surgery. The neurological status of the patients was assessed by the modified Japanese Orthopaedic Association Scale (mJOAS). X-rays were conducted before and after surgery.
  
  
  RESULTS
  52 patients were treated by a single-level (n=27) or a multi-level approach (n=25) more than 5 years ago. A significant improvement of the neurological status could be seen even 5 years or more after surgery in both groups without differences. After one year no further improvement could be observed. In the single-level group a trend to a subsequent loss of lordotic correction could be seen. Anterior plates were only used in the multi-level group.
  
  
  CONCLUSIONS
  The anterior approach is an effective procedure to improve the symptoms of a CSM for many years. The risk of a multi-level pathology does not appear to exceed the risks of a single-level pathology concerning clinical long-term outcome after surgery. The clinical success is not hindered by a loss of correction in this specific setting.
authors.affiliation: Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Bayerl
authors.forename: Kurt
authors.initials: K
authors.lastname: Wiendieck
authors.forename: Daniel
authors.initials: D
authors.lastname: Koeppen
authors.forename: Miroslav
authors.initials: M
authors.lastname: Topalovic
authors.forename: Anett
authors.initials: A
authors.lastname: Übelacker
authors.forename: Stefan
authors.initials: S
authors.lastname: Kroppenstedt
authors.forename: Mario
authors.initials: M
authors.lastname: Cabraja
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008141:Lordosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D009460:Neurologic Examination; D019637:Orthopedic Procedures; D010147:Pain Measurement; D011859:Radiography; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D055009:Spondylosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Degenerative disc disease; Spine; Surgery