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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Relationship between developmental canal stenosis and surgical results of anterior decompression and fusion in patients with cervical spondylotic myelopathy

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
Jing Tao Zhang, Lin Feng Wang, Yue Ju Liu, Jun Ming Cao, Jie Li, Shuai Wang, Yong Shen
Wichtige Hinweise
Jing Tao Zhang and Yue Ju Liu contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

JZ and LW drafted the manuscript, and participated in concept and design. JZ, YL, and JC conducted the study, performed follow up, carried out the acquisition of data, and interpreted the data, under YS’s supervision. JL and SW both helped to analyze data and revised the manuscript. YS participated in concept and design, drafted the manuscript. All authors read and approved the final manuscript.

Authors' information

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Availability of data and materials

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Abstract

Background

Anterior cervical decompression and fusion (ACDF) has long been the preferred treatment for cervical spondylotic myelopathy (CSM). However, few studies have focused on surgical results of CSM in patients with developmental canal stenosis (DCS). The purpose of this study was to investigate DCS as a comorbidity in patients with CSM and the correlation between surgical results and DCS.

Methods

From January 1995 to December 2005, 122 patients treated with ACDF for CSM were enrolled in this retrospective study. Pavlov’s ratio was used to evaluate cervical spinal canal size, with a value of < 0.82 at least one level indicating DCS. Patients were divided into two groups: those with DCS preoperatively (DCS group, n = 50 [41.0 %]) and those without DCS (non-DCS group, n = 72). Clinical data and radiological parameters were compared between groups.

Results

There were no significant differences in preoperative and 2-year follow-up Japanese Orthopedic Association scores between groups. Both groups achieved satisfactory fusion rates (DCS, 92.0 %; non-DCS, 93.0 %). Adjacent-segment degeneration (ASD) was detected in 66.0 % of patients in the DCS group and in 43.0 % of patients in the non-DCS group (p = 0.01). However, there was no significant difference in the incidence of ASD requiring surgery between groups (p = 0.20).

Discussion

DCS is a common comorbidity in patients with CSM. The findings of this study have added knowledge on the correlation between DCS and ASD after anterior fusion surgery.

Conclusions

DCS did not affect neurologic improvement postoperatively at short-term follow-up. Although DCS increased the incidence of ASD after anterior fusion, it did not predict ASD requiring surgery. Therefore, patients with DCS must receive close follow-up.
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