title: Expansion Open-door Laminoplasty With Foraminotomy Versus Anterior Cervical Discectomy and Fusion for Coexisting Multilevel Cervical Myelopathy and Unilateral Radiculopathy.
abstract: METHODS
  This was a clinical prospective study.
  
  
  OBJECTIVE
  To assess whether clinical and radiologic outcomes differ between expansion open-door laminoplasty with foraminotomy (EOLF) and anterior cervical discectomy and fusion (ACDF) in the treatment of coexisting multilevel cervical myelopathy and unilateral radiculopathy (CMUR).
  
  
  BACKGROUND
  No reports to date have compared clinical outcomes between anterior and posterior decompression for CMUR.
  
  
  METHODS
  We prospectively performed ACDF (n=59) in 2004, 2006, and 2008 and EOLF (n=62) in 2005, 2007, and 2009. The Japanese Orthopedic Association (JOA) score and recovery rate were evaluated. For radiographic evaluation, the lordotic angle and range of motion at C2-C7 were investigated.
  
  
  RESULTS
  Only 110 patients could be followed for >3 years (EOLF/ACDF: 56/54; follow-up rate, 90.9%). Demographics were similar between the 2 groups. Compared with ACDF, in EOLF group there were shorter operating time (144 vs. 178 min), less bleeding (175 vs. 192 mL), and fewer complications (P<0.05). Results of JOA score and recovery rate, at 3-year postoperative follow-up, showed no statistical difference for the 2 groups. Cervical lordosis of ACDF increased from 13.7 to 16.2 degrees, whereas that of EOLF group decreased from 14.6 to 13.3 degrees (P<0.05). The percentage of range of motion declined in the 2 groups (ACDF/EOLF), 57.4% versus 74.7% (P<0.05).
  
  
  CONCLUSIONS
  The 2 surgical procedures have similar clinical effects in treating multisegmental CMUR. However, the EOLF group demonstrated shorter operative time, less blood loss, and fewer complications; therefore, it proved to be a more effective and safer method.
authors.affiliation: *Department of Spine Surgery, Tianjin Union Medicine Center, Tianjin Institute of Spine Surgery†Nankai Medical School, Nankai University, Tianjin, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Fang
authors.forename: Rong
authors.initials: R
authors.lastname: Tian
authors.forename: Tian-wei
authors.initials: TW
authors.lastname: Sun
authors.forename: Sandip K
authors.initials: SK
authors.lastname: Yadav
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.forename: Shui-qing
authors.initials: SQ
authors.lastname: Xie
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome