scholarly journals Comparison of clinical outcomes and safety between laminectomy with instrumented fusion versus laminoplasty for the treatment of multilevel cervical spondylotic myelopathy

Medicine ◽  
2019 ◽  
Vol 98 (8) ◽  
pp. e14651 ◽  
Author(s):  
Xiang Lin ◽  
Jie Cai ◽  
Chuan Qin ◽  
Qinghua Yang ◽  
Zengming Xiao
Keyword(s):  
Clinical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Instrumented Fusion ◽  
Multilevel Cervical Spondylotic Myelopathy

scholarly journals Anterior Controllable Antedisplacement and Fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS): a retrospective study of 45 cases

2019 ◽  
Author(s):  
Xi Luo ◽  
Kaiqiang Sun ◽  
Jingchuan Sun ◽  
Shunmin Wang ◽  
Yuan Wang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Operation Time ◽  
Significant Difference ◽  
Csf Leakage ◽  
One Year ◽  
Neck Disability ◽  
Multilevel Cervical Spondylotic Myelopathy

Abstract Background To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), and compare ACAF with hybrid decompression fixation (HDF). Methods A retrospective analysis of 85 cases with MCSMSS was carried out. 45 patients were treated with ACAF, while 40 patients were treated with HDF. The operation time, intraoperative bleeding volume, postoperative complications, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, Computed Tomography (CT) transverse measurement, cervical curvature and Kang's grade were compared between two groups. Results The patients were followed up for 12 to 17 months. Compared with HDF, ACAF group achieved better decompression according to CT measurement and Kang’s grade (P < 0.05), and recovered to a greater cervical Cobb’s angle (P < 0.05). However, JOA score and NDI index showed no significant difference one year after surgery (P＞0.05). Additionally, ACAF presented longer operation time and greater intraoperative blood loss (P < 0.05). As to complications, ACAF developed less incidences of cerebrospinal fluid examination (CSF) leakage, neurologic deterioration, epidural hematoma and C5 palsy by comparing with HDF. Conclusions ACAF is an effective method for the treatment of MCSMSS. Compared with HDF, ACAF has the advantages of significant decompression, increasing cervical curvature, and reducing the incidences of complications.

scholarly journals Sagittal Alignment of a Strut Graft Affects Graft Subsidence and Clinical Outcomes of Anterior Cervical Corpectomy and Fusion

2017 ◽  
Vol 11 (5) ◽  
pp. 739-747 ◽  
Author(s):  
Koun Yamauchi ◽  
Kazunari Fushimi ◽  
Kei Miyamoto ◽  
Akira Hioki ◽  
Katsuji Shimizu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Sagittal Alignment ◽  
Clinical Results ◽  
Recovery Ratio ◽  
Strut Graft ◽  
Cervical Corpectomy ◽  
Group I ◽  
Graft Subsidence ◽  
Anterior Cervical Corpectomy

<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to investigate the influence of sagittal alignment of the strut graft on graft subsidence and clinical outcomes after anterior cervical corpectomy and fusion (ACCF).</p></sec><sec><title>Overview of Literature</title><p>ACCF is a common technique for the treatment of various cervical pathologies. Although graft subsidence sometimes occurs after ACCF, it is one cause for poor clinical results. Malalignment of the strut graft is probably one of the factors associated with graft subsidence. However, to the best of our knowledge, no prior reports have demonstrated correlations between the alignment of the strut graft and clinical outcomes.</p></sec><sec><title>Methods</title><p>We evaluated 56 patients (33 men and 23 women; mean age, 59 years; range, 33–84 years; 45 with cervical spondylotic myelopathy and 11 with ossification of the posterior longitudinal ligament) who underwent one- or two-level ACCF with an autogenous fibular strut graft and anterior plating. The Japanese Orthopaedic Association (JOA) score recovery ratio for cervical spondylotic myelopathy was used to evaluate clinical outcomes. The JOA score and lateral radiograms were evaluated 1 week and 1 year postoperatively. Patients were divided into two groups (a straight group [group I] and an oblique group [group Z]) based on radiographic assessment of the sagittal alignment of the strut graft.</p></sec><sec><title>Results</title><p>Group I showed a significantly greater JOA score recovery ratio (<italic>p</italic>&lt;0.05) and a significantly lower graft subsidence than group Z (<italic>p</italic>&lt;0.01).</p></sec><sec><title>Conclusions</title><p>Our findings suggest that a straight alignment of the strut graft provides better clinical outcomes and lower incidence of graft subsidence after ACCF. In contrast, an oblique strut graft can lead to significantly increased strut graft subsidence and poor clinical results.</p></sec>

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