A Comparison of Anterior Cervical Corpectomy and Fusion Combined With Artificial Disc Replacement and Cage Fusion in Patients With Multilevel Cervical Spondylotic Myelopathy. Issue 16 (15th August 2015)

• Record Type: Journal Article
• Authors: Mao, Ningfang; Wu, Jinhui; Zhang, Ye; Gu, Xiaochuan; Wu, Yungang; Lu, Chunwen; Ding, Muchen; Lv, Runxiao; Li, Ming; Shi, Zhicai
• Is Part Of: Spine. Volume 40:Issue 16(2015)
• Publication Date: 2015-08-15
• Subjects: Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000000957
• Languages: English
• ISSNs: 0362-2436

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Study Design.</title> <p>A retrospective study.</p> </sec> <sec> <title>Objective.</title> <p>The aim of this study was to compare clinical and radiological outcomes of anterior cervical corpectomy and fusion (ACCF) combined with artificial disc replacement (C-ADR) and ACCF combined with anterior cervical discectomy and fusion (ACDF) in patients with consecutive 3-level cervical spondylotic myelopathy (CSM).</p> </sec> <sec> <title>Summary of Background Data.</title> <p>The optimal surgical strategy for multilevel CSM (MCSM) remains undefined. C-ADR maintains motion at the level of the surgical procedure and decreases strain on the adjacent segments. The clinical results of multilevel C-ADR have not yet been elucidated. ACCF combined with 1-level C-ADR for the treatment of consecutive 3-level CSM may be a reasonable alternative to 3-level fusion.</p> </sec> <sec> <title>Methods.</title> <p>We retrospectively reviewed the histories of patients who underwent surgery for consecutive 3-level CSM between C3–4 and C6–7 from June 2007 to August 2011. A total of 42 patients were divided into 2 groups. Group A (n = 19) underwent ACCF combined with 1-level C-ADR; group B (n = 23) underwent ACCF combined with 1-level ACDF. We compared perioperative parameters, clinical parameters, and radiological parameters.</p> </sec> <sec> <title>Results.</title> <p>There were no significant differences in the average age, sex ratio, the preoperative heights of the disc space or average blood loss between the 2 groups. Group A had longer operation times than group B (<italic>P</italic> < 0.05). During the follow-up period, group A showed a better Neck Dysfunction Index recovery (<italic>P</italic> < 0.05) at 24 months postoperatively, and less visual analogue scale scores at 12 and 24 months postoperatively (<italic>P</italic> < 0.05 and <italic>P</italic> < 0.001, respectively). Moreover, group A exhibited better C2–C7 range of motion recovery at 6, 12, and 24 months postoperatively (<italic>P</italic> < 0.05, respectively).</p> </sec> <sec> <title>Conclusion.</title> <p>Group A was superior to Group B in terms of better Neck Dysfunction Index recovery, less intermediate term pain, and better C2–C7 ROM recovery. ACCF hybrid 1-level C-ADR may be a suitable choice for the management of 3-level CSM in appropriate patients.</p> <p> <bold>Level of Evidence:</bold> 3</p> </sec> </abstract>