| Objectives：Patients with cervical myelopathy associated with changes in cervical lordosisand ventral disease are indications for anterior approach.As bone graft present manydrawbacks, titanium cage has been recently introduced for this indication. Anteriorlocking plate has many advantages, such as providing structural rigidity, preventinggraft loss, avoiding late kyphosis and pseudarthrosis occurred in the fusion ofmultiple segments. Anterior cervical corpectomy and fusion is widely used inclinical practice. The purpose of this study was to investigate the clinical andradiological outcomes of the anterior cervical corpectomy and fusion with anteriorplating and placing titanium mesh for cervical spondylotic myelopathyMethods：A total of35patients (19males,16females,mean age58years)underwentcervical corpectomy and reconstruction using titanium cage and anterior plate fromJanuary2010to January2013was retrospectively reviewed. the neurologicalfunction was evaluated by mJOA，VAS scoring systemsing preoperatively and at3months,6months and1year. Radiolographs were taken at the same points offollow-up to observe intervertebral height and cervical alignment. Fusion wasevaluated on flexion–extension radiographs at1year.Results:The VAS was7.2±1.2before surgery and decreased to2.8±1.5at a1-yearfollow-up.It was significant difference (p<0.001) compared with the preoperativescore,and the mean mJOA increased from12.8±0.5to16.2±0.5at1yearpostoperatively（p<0.001）. The mean cervical lordosis significantly increased frompreoperative9.2±1.8°six month’14.5±1.3°to one year’13.7±1.7°(p<0.001). Themean intervertebral height decreased from preoperative23.1±0.8mm to six month’21.6±0.4mm to one year’21.3±0.2mm, however, there were no significant changessix months after operation versus during the follow-up (P>0.05);The fusion rate was 100%at1year. The average time required for fusion was6.2±2.7months. Noinstrument failure was noted.2cases with postoperative dyspnea improved graduallyafter6weeks.1case with cerebrospinal fluid leakage, which was treated by lumbardrainage, improved gradually after1week. No complications of infections,recurrentlaryngeal nerve palsies, esophageal or tracheal ruptures occured.Conclusion：The application of the anterior cervical corpectomy and fusion with anteriorplating and placing titanium mesh has be proved to be favor of restoring theintervertebral height and cervical alignment.It is a safe and effective surgical methodfor the treatment of cervical spondylotic myelopathy. |
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