Comparative Study Of The Outcomes Of Noncontiguous Anterior Corpectomies And Fusion And Laminoplasty For Multilevel Cervical Spondylotic Myelopathy

Objective:To compare the short-term surgical outcomes of noncontiguous anterior corpectomies and fusion(NACF) and open-door laminoplasty for patients with multilevel cervical spondylotic myelopathy (MCSM) and to analyse the advantages and defects of both the two surgical methods.Data and method:The author collected the information of nineteen patients of multilevel cervical spondylotic myelopathy were treated with noncontiguous anterior corpectomies and fusion(NACF) within the latest 4 years . The same to 23 patients of multilevel cervical spondylotic myelopathy who were treated with poeterior open-door laminoplasty with/without instrumented fusion within the same period. They were followed up more than 12 months(18 months on anverage).The Japanese Orthopedic Association scoring system(JOA) was used to evaluate cervical neurological functions and were compared between the two groups preoperatively and at 12-month follow-up. Also the cervical spine curvertures were measured at the same times. The complications of both groups were recorded too.Result: The mean surgical time was 188.9±9.1min(120～300min)and the mean blood loss volume was 371.1±36.7ml(200～800ml)in the anterior group.The mean surgical time and the mean blood loss volume was 198.1±7.5min(150～280min)and 471.4±39.6ml(200～900ml)respectively in the posterior group,the di C5 nerve paralysis and three patients had axial pain.Conclusion: The noncontiguous anterior corpectomies and fusion(NACF) is safe and has a high fusion rate for multilevel cervical spondylotic myelopathy (MCSM). The NACF has a similar spinal function recovery rate with the open-door laminoplasty. The NACF has an advantage in reconstructing and maintaining the cervical curvature.