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Chirurgia 2017 August;30(4):117-24

DOI: 10.23736/S0394-9508.16.04568-X


lingua: Inglese

Anterior surgical approach for cervical spondylotic myelopathy: clinical and radiological outcomes

Inan GEZGIN 1 , Ibrahim ERKUTLU 2, Mehmet ALPTEKIN 2, Murat GEYIK 2, Abdulvahap GÖK 2

1 Department of Neurosurgery, Kafkas University Faculty of Medicine, Kars, Turkey; 2 Department of Neurosurgery, Gaziantep University Faculty of Medicine, Gaziantep, Turkey


BACKGROUND: The optimal surgical approach for cervical spondylotic myelopathy (CSM) has not been clearly defined and remains as a controversial issue. To investigate the clinical and radiological outcomes of two different anterior surgical approaches in the surgical treatment of CSM.
METHODS: This retrospective study was carried out on the medical files of 44 CSM patients (8 women, 36 men) treated surgically between 2001 and 2009 in the neurosurgery department of our tertiary center. Either multi-level anterior cervical discectomy and fusion (ACDF) (n=20) or anterior cervical corpectomy and fusion (ACCF) (n=24) was performed. The average ages in ACDF and ACCF groups were 53.85±11.51 (range 35 to 77) and 55.29±10.84 (range: 37 to 77), respectively. The patients were followed-up for 45.40 months (range: 12 to 96) in ACDF group and for 40.33 months (range: 12 to 62 months) in ACCF group. Postoperative alteration of clinical and radiological parameters were noted and compared to their preoperative values.
RESULTS: We observed that postoperative cervical lordosis angle values, hyperintensity on T2 weighted magnetic resonance images and Modified Japanese Orthopedic Association Scores were significantly improved after surgery in both ACDF (p=0.001) and ACCF (p<0.001) groups in comparison to their initial preoperative status.
CONCLUSIONS: Results of the present study imply that both ACDF and ACCF yield satisfactory clinical and radiological outcomes in the management of CSM. Determination of the surgical approach for CSM must be made on an individualized basis and clinical / radiological measures must be taken into account during making the decision.

KEY WORDS: Spinal cord diseases - Surgical procedures, operative - Treatment outcome

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