19 Harley St, London, W1G 9QJ, UK

A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy

BACKGROUND: The optimal surgical approach for multilevel cervical spondylotic myelopathy (CSM) has not been defined, and the relative merits of multilevel anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy (2-level or skip 1-level corpectomy) and fusion (ACCF) remain controversial. However, few comparative studies have been conducted on these two surgical approaches. METHODS: This study retrospectively reviewed the case histories of 120 patients that underwent surgical treatment for 3- or 4-level CSM from July 2003 to June 2008. One hundred and twenty patients (81 male and 39 female) of mean age 58.3+/-9.8 years (37-78) were included. The study compared perioperative parameters (blood loss, operation times), complications [surgery-related complications (CSF, hoarseness, epidural hematoma, C5-palsy, dysphagia), instrumentation and graft related complications (dislodgement, subsidence)], clinical parameters [Japanese Orthopedic Association (JOA) scores, Neck Dysfunciton Index (NDI) scores], and radiologic parameters (segmental lordosis, fusion rate). RESULTS: At a minimum of 2-year follow-up, both ACDF and ACCF groups demonstrated a significant increase in the JOA scores (preoperatively 9.25+/-1.9 and 8.86+/-1.9, postoperatively 13.86+/-1.6 and 13.27+/-1.8, respectively), segmental lordosis (preoperatively 9.79+/-3.4 and 9.54+/-3.0, postoperatively 17.75+/-2.6 and 14.49+/-2.5, respectively) and NDI scores (preoperatively 12.56+/-3.0 and 12.21+/-3.4, postoperatively 3.44+/-1.7 and 5.68+/-2.6, respectively). Six patients (2 dislodgement, 4 subsidence) in ACCF group had instrumentation and graft related-complications and they had no obvious neurological symptoms without a second operation. Blood loss (102.81+/-51.3 and 149.05+/-74, respectively, P=0.000), NDI scores (P=0.000), and instrumentation and graft related-complications (P=0.032) were significantly lower in the ACDF group, whereas operation time (138.07+/-30.9 and 125.08+/-26.4, respectively, P=0.021) and segmental lordosis (P=0.000) were significantly greater in the ACDF group. Other parameters were not significantly different in the two groups. CONCLUSIONS: Surgical managements of 3- or 4-level CSM by ACDF or ACCF showed no significant differences in terms of achieved clinical symptom improvements, with the exception of better postoperative NDI scores in ACDF. In addition, ACDF is better than ACCF in terms of blood loss, lordotic curvature improvement and instrumentation and graft related-complication rates, with the exception of operation times

Keywords : Adult,adverse effects,Aged,blood,China,complications,diagnostic imaging,Diskectomy,epidemiology,Female,Hematoma,history,Humans,instrumentation,Intervertebral Disc Degeneration,Lordosis,Male,methods,Middle Aged,Neck,Orthopedics,pathology,Patients,physiopathology,Postoperative Complications,prevention & control,Radiography,Retrospective Studies,Spinal Cord Compression,Spondylosis,surgery,Time,Universities,Vertebroplasty,, Comparison,Anterior,Cervical,Discectomy, rsi finger pain

Date of Publication : 2012 Mar

Authors : Lin Q;Zhou X;Wang X;Cao P;Tsai N;Yuan W;

Organisation : Department of Orthopedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

Journal of Publication : Eur Spine J

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21826497

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy | Psychology clinics london

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810