A Comparative Study Of Short Term Clinical Effect Between Anterior And Posterior Decompression For Multilevel Cervical Spondylotic Myelopathy

Objective: The author compared the anterior and posterior approachused to treat MCSM,focusing on short term clinical outcome andsagittal alignment,to provide the clinical basis for the surgery.Method:This subject analyzed35MCSM cases in the orthopedic depart-ment of the Union Affiliated Hospital of Fujian University from Apr2010to Oct2013. The information of these cases was collected fromdocumentation.All the cases were followed up3months after oper-ation.Cohorts were divided into as follow:Group A,20cases whoundertook anterior approach;Group B,15cases who undertook posteriorapproach. Neural function and Cervical sagittal alignment wereperformed after operation.According to JOA score,preoperative scoreand postoptive follow-up score were compared,improvement rates werecaleulated respectively. According to D numerical value,preoperativevalue and postoperative follow-up value were compared.Operation timeand intraopertaive blood loss were compared in two groupsrespectively.Results:Postoperative JOA score was significantly improved comparedwith preoperative JOA score both in group A and group B.There was notsignificant difference in improvement rate between group A and groupB.Both group A and group B can significantly improve the neurologicalfunction of the patient.There was not significant difference in shortterm clinical effect between group A and group B.Postoprative Dnumerical value was significantly improved compared with preoprativeD numerical value in group A.Postoperative D numerical value wasdescended compared with preoprative D numerical value in group B.There was no significant statistical difference between two groupsin operation time.But intraoperative blood loss in group B was morethan in group A.Conclusion:These results demonstrate that both anterior decompre-ssion fusion and single open-door laminoplasty(with instrumentation)are effective procedures to improve the neurological outcome ofpatient with MCSM.There was not significant difference in short termclinical effect between two groups.There was no significant differ-ence between two groups in Operation time.The intraoperative bloodloss in posterior opration was more than in anterior opration.Anterior opration was more helpful to resume the Cervical sagittalalignment.Posterior operation was loss part of sagittal alignment.