Anzeige
Erschienen in:
01.08.2009 | Original Article
Comparative study of anterior versus posterior decompression in elderly patients of cervical myelopathy with co-morbid conditions
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 6/2009
Einloggen, um Zugang zu erhaltenAbstract
Study design
Prospective.
Objective
To assess the results of laminectomy in patients suffering from multilevel multidirectional compressive cervical myelopathy with co-morbid conditions and to compare results of anterior and laminectomy clinically, radiologically and functionally.
Summary of background data
Cervical myelopathy or myeloradiculopathy is a progressive degenerative disorder that usually starts in the middle age. It leads to circumferential cord compression leading to a constellation of signs and symptoms.
Methods
Prospective study of 30 cases in which we had compared the results of anterior and posterior decompression surgery. Our follow-up ranged from 18 to 60 months with an average follow-up of 31.8 months.
Results
Eighteen patients underwent laminectomy by posterior midline approach in which lamina and if required, medial one-third of the facet was also removed. Diskectomy and bone grafting was done in eight patients by standard anterior approach with removal of disc at two or three levels. Corpectomy and diskectomy above and below with bone grafting was done in four patients. Out of these two were fused with tricortical iliac crest and two with fibula.
Conclusion
Anterior decompression is the gold standard. However, in medically unfit patients with multi-level circumferential compression laminectomy is an equally rewarding option.