A Comparison between Anterior and Posterior Surgical Approaches in the Treatment of Cervical Spondylotic Myelopathy

Background: Cervical spondylotic myelopathy (CSM) is one of the most common dysfunctions of spinal cord which occurs due to degenerative changes in cervical spine disc and facet joints. The management of multilevel spondylotic myelopathy is always controversial. The posterior approaches are always preferable in multiple level spondylosis. But according to newer studies, anterior approaches have similar results. Aim of the study was to compare the efficacy of posterior and anterior approaches in multilevel cervical myelopathy.Methods: This study includes all patients with multilevel cervical spondylotic myelopathy who have undergone decompression surgery with fusion. Detailed preoperative and post-operative assessment was done according to modified Japanese Orthopedic Association scoring system.Results: Eighty eight patients of CSM surgical cases were selected for this study and 29 cases of multi-level CSM were observed. And they were randomly selected for anterior and posterior approaches. Sixteen cases anterior approach was done either ACDF or Corpectomy with fusion. Mean age of study was 51.63 years with 64 males and 24 females. The spinal cord level at which most surgeries did was C5/6, 62 cases. While at level C4/5, it was 49 and at level C3/4 and C6/7, it was 35 and 36 respectively.Conclusions: Both anterior approach and posterior approaches were associated with betterment in postoperative neurological function for multilevel CSM. And there is no significant advantage in doing anterior approach in multilevel CSM.

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Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

Recent Advances in Biology and Medicine ◽

10.18639/rabm.2017.03.470880 ◽

2017 ◽

Vol 03 ◽

pp. 83 ◽

Cited By ~ 2

Author(s):

Putu Eka Mardhika ◽

Ketut Kris Adi Marta ◽

Sri Maliawan ◽

Tjokorda GB Mahadewa ◽

◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Degenerative Disease ◽

Surgical Approaches ◽

Research Papers ◽

Severe Morbidity ◽

Advantages And Disadvantages ◽

Pubmed Database ◽

The Common ◽

Surgical Treatments ◽

Anterior Cervical Corpectomy

This paper reviews the pathophysiology of cervical spondylotic myelopathy (CSM) and several surgical approaches for the treatment of CSM. CSM is a degenerative disease with severe morbidity. The pathophysiology of CSM involves static, dynamic, and ischemic factors. The management of mild CSM typically involves conservative treatments and medication; whereas, moderate and severe CSM are better treated surgically. Surgical treatments for CSM are basically classified into anterior and posterior surgeries. The common techniques are anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), laminectomy, and laminoplasty. Each technique has its own advantages and disadvantages. In this paper, we review the research papers from PubMed database to elaborate the advantages and disadvantages of each technique.

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