Segmental anterior cervical corpectomy and fusion with preservation of middle vertebrae in the surgical management of 4-level cervical spondylotic myelopathy.
OBJECTIVE
To compare perioperative parameters, clinical outcomes, radiographic parameters, and complication rates of segmental anterior cervical corpectomy and fusion (sACCF) plus preservation of middle vertebrae with those of cervical laminectomy plus fusion (CLF) in 67 patients with 4-level cervical spondylotic myelopathy (CSM).


METHODS
Between July 2006 and May 2012, 67 consecutive patients [42 males and 25 females; mean age 57.8 years (range 34-77 years)] with 4-level CSM who underwent surgery and were followed for more than 1 year were enrolled in this study and divided into sACCF and CLF groups. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters.


RESULTS
Significant improvements were seen from preoperative to postoperative in both groups for all three measures of clinical outcome; between-group comparison revealed no significant difference for two of the three measures and significantly better scores for the CLF group in the third. Satisfaction was rated as excellent or good by 79.5 % of the sACCF group and 71.4 % of the CLF group, which was not a significant difference. Mean postoperative cervical lordosis was significantly greater in the sACCF group than in the CLF group. Blood loss and operative time were significantly greater in the CLF group than in the sACCF group and complication rate significantly lower for the sACCF group.


CONCLUSIONS
sACCF with preservation of middle vertebrae is a safe, reliable, and effective alternative procedure for the treatment of 4-level CSM.
Department of Orthopedics, First Affiliated Hospital of PLA General Hospital, Beijing, People's Republic of China.
Zhonghai
Z
Li
Zhenggang
Z
Guo
Shuxun
S
Hou
Yantao
Y
Zhao
Hongbin
H
Zhong
Shunzhi
S
Yu
Tiesheng
T
Hou
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D008141:Lordosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion; D055009:Spondylosis / Q000601:surgery*