Skip to main content
Erschienen in: International Orthopaedics 8/2018

24.02.2018 | Original Paper

Anterior cervical corpectomy and fusion versus discectomy and fusion for the treatment of two-level cervical spondylotic myelopathy: analysis of sagittal balance and axial symptoms

verfasst von: Yijian Zhang, Hao Liu, Huilin Yang, Bin Pi

Erschienen in: International Orthopaedics | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the postoperative sagittal balance and occurrence of axial symptoms between anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) for the treatment of two-level cervical spondylotic myelopathy (CSM).

Methods

A total of 71 consecutive patients who underwent ACCF or ACDF for two-level CSM in our institution from January 2014 to December 2016 were retrospectively reviewed. Of these patients, 30 (17 males, 13 females) were subjected to ACCF, and 41 (20 males, 21 females) were treated with ACDF. Perioperative data, radiographic parameters, clinical outcomes, and axial symptom occurrence were compared between the two groups.

Results

The average follow-up durations were 13.7 ± 3.9 months in the ACCF group and 13.4 ± 3.3 months in the ACDF group. The volume of blood loss was significantly lower in the ACDF group than in the ACCF group, and the operation time of the former was significantly shorter than that of the latter. The postoperative global lordotic angle and T1 slope were significantly larger in the ACCF group than in the ACDF group in each follow-up. The occurrence of postoperative axial symptoms was significantly lower in the ACDF group than in the ACCF group.

Conclusion

The volume of blood loss was lower and the operation time was shorter in ACDF than in ACCF for the treatment of two-level CSM. Sagittal balance was better in the ACDF group than in the ACCF group, and this observation may lead to a reduced occurrence of axial symptoms.
Literatur
5.
Zurück zum Zitat Burkhardt JK, Mannion AF, Marbacher S, Dolp PA, Fekete TF, Jeszenszky D, Porchet F (2013) A comparative effectiveness study of patient-rated and radiographic outcome after 2 types of decompression with fusion for spondylotic myelopathy: anterior cervical discectomy versus corpectomy. Neurosurg Focus 35(1):E4. https://doi.org/10.3171/2013.3.focus1396 CrossRefPubMed Burkhardt JK, Mannion AF, Marbacher S, Dolp PA, Fekete TF, Jeszenszky D, Porchet F (2013) A comparative effectiveness study of patient-rated and radiographic outcome after 2 types of decompression with fusion for spondylotic myelopathy: anterior cervical discectomy versus corpectomy. Neurosurg Focus 35(1):E4. https://​doi.​org/​10.​3171/​2013.​3.​focus1396 CrossRefPubMed
9.
Zurück zum Zitat Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H (1999) Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord 12(1):50–56CrossRefPubMed Kawakami M, Tamaki T, Yoshida M, Hayashi N, Ando M, Yamada H (1999) Axial symptoms and cervical alignments after cervical anterior spinal fusion for patients with cervical myelopathy. J Spinal Disord 12(1):50–56CrossRefPubMed
12.
Zurück zum Zitat Bai J, Zhang X, Zhang D, Ding W, Shen Y, Zhang W, Du M (2015) Impact of over distraction on occurrence of axial symptom after anterior cervical discectomy and fusion. Int J Clin Exp Med 8(10):19746–19756PubMedPubMedCentral Bai J, Zhang X, Zhang D, Ding W, Shen Y, Zhang W, Du M (2015) Impact of over distraction on occurrence of axial symptom after anterior cervical discectomy and fusion. Int J Clin Exp Med 8(10):19746–19756PubMedPubMedCentral
20.
Zurück zum Zitat Sakai K, Yoshii T, Hirai T, Arai Y, Shinomiya K, Okawa A (2017) Impact of the surgical treatment for degenerative cervical myelopathy on the preoperative cervical sagittal balance: a review of prospective comparative cohort between anterior decompression with fusion and laminoplasty. Eur Spine J 26(1):104–112. https://doi.org/10.1007/s00586-016-4717-8 CrossRefPubMed Sakai K, Yoshii T, Hirai T, Arai Y, Shinomiya K, Okawa A (2017) Impact of the surgical treatment for degenerative cervical myelopathy on the preoperative cervical sagittal balance: a review of prospective comparative cohort between anterior decompression with fusion and laminoplasty. Eur Spine J 26(1):104–112. https://​doi.​org/​10.​1007/​s00586-016-4717-8 CrossRefPubMed
22.
Zurück zum Zitat Smith JS, Lafage V, Ryan DJ, Shaffrey CI, Schwab FJ, Patel AA, Brodke DS, Arnold PM, Riew KD, Traynelis VC, Radcliff K, Vaccaro AR, Fehlings MG, Ames CP (2013) Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study. Spine 38(22 Suppl 1):S161–S170. https://doi.org/10.1097/BRS.0b013e3182a7eb9e CrossRefPubMed Smith JS, Lafage V, Ryan DJ, Shaffrey CI, Schwab FJ, Patel AA, Brodke DS, Arnold PM, Riew KD, Traynelis VC, Radcliff K, Vaccaro AR, Fehlings MG, Ames CP (2013) Association of myelopathy scores with cervical sagittal balance and normalized spinal cord volume: analysis of 56 preoperative cases from the AOSpine North America Myelopathy study. Spine 38(22 Suppl 1):S161–S170. https://​doi.​org/​10.​1097/​BRS.​0b013e3182a7eb9e​ CrossRefPubMed
Metadaten
Titel
Anterior cervical corpectomy and fusion versus discectomy and fusion for the treatment of two-level cervical spondylotic myelopathy: analysis of sagittal balance and axial symptoms
verfasst von
Yijian Zhang
Hao Liu
Huilin Yang
Bin Pi
Publikationsdatum
24.02.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 8/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3804-3

Weitere Artikel der Ausgabe 8/2018

International Orthopaedics 8/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.