title: A prospective randomized trial comparing anterior cervical discectomy and fusion versus plate-only open-door laminoplasty for the treatment of spinal stenosis in degenerative diseases.
abstract: For three or more involved cervical levels, there is a debate over which approach yields the best outcomes for the treatment of multilevel cervical degenerative disease. Our objective is to compare the radiological and clinical outcomes of two treatments for multilevel cervical degenerative disease: anterior cervical discectomy and fusion (ACDF) versus plate-only open-door laminoplasty (laminoplasty).
  
  
  
  Patients were randomized on a 1:1 randomization schedule with 17 patients in the ACDF group and 17 patients in the laminoplasty group. Clinical outcomes were assessed by a visual analog scale (VAS), Japanese Orthopedic Association (JOA) scores, operative time, blood loss, rates of complications, drainage volume, discharge days after surgery, and complications. The cervical spine curvature index (CI) and range of motion (ROM) were assessed with radiographs.
  
  
  
  The mean VAS score, the mean JOA score, and the rate of complications did not differ significantly between groups. The laminoplasty group had greater blood loss, a longer operative time, more drainage volume, and a longer hospital stay than the ACDF group. There were no significant differences in the CI and ROM between the two groups at baseline and at each follow-up time point. ROM in both groups decreased significantly after surgery.
  
  
  
  Both ACDF and laminoplasty are effective and safe treatments for multilevel cervical degenerative disease. ACDF causes fewer traumas than laminoplasty.
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Yun-Qi
authors.initials: YQ
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Xi-Lei
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Xiao-Gang
authors.initials: XG
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Chong
authors.initials: C
authors.lastname: Bian
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
authors.forename: Han-Ming
authors.initials: HM
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Shanghai Pudong HospitalFudan University Pudong Medical Center, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai, 201399, People's Republic of China. hjm19611009@163.com.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Huang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan HospitalFudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China. dong.jian@zs-hospital.sh.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D065406:Laminoplasty / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000601:surgery*
keywords: ACDF; Laminoplasty; Multilevel cervical degenerative disease; Random control trail