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European Spine Journal

Erschienen in:

01.07.2014 | Original Article

Segmental anterior cervical corpectomy and fusion with preservation of middle vertebrae in the surgical management of 4-level cervical spondylotic myelopathy

verfasst von: Zhonghai Li, Zhenggang Guo, Shuxun Hou, Yantao Zhao, Hongbin Zhong, Shunzhi Yu, Tiesheng Hou

Erschienen in: European Spine Journal | Ausgabe 7/2014

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Abstract

Purpose

To compare perioperative parameters, clinical outcomes, radiographic parameters, and complication rates of segmental anterior cervical corpectomy and fusion (sACCF) plus preservation of middle vertebrae with those of cervical laminectomy plus fusion (CLF) in 67 patients with 4-level cervical spondylotic myelopathy (CSM).

Methods

Between July 2006 and May 2012, 67 consecutive patients [42 males and 25 females; mean age 57.8 years (range 34–77 years)] with 4-level CSM who underwent surgery and were followed for more than 1 year were enrolled in this study and divided into sACCF and CLF groups. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters.

Results

Significant improvements were seen from preoperative to postoperative in both groups for all three measures of clinical outcome; between-group comparison revealed no significant difference for two of the three measures and significantly better scores for the CLF group in the third. Satisfaction was rated as excellent or good by 79.5 % of the sACCF group and 71.4 % of the CLF group, which was not a significant difference. Mean postoperative cervical lordosis was significantly greater in the sACCF group than in the CLF group. Blood loss and operative time were significantly greater in the CLF group than in the sACCF group and complication rate significantly lower for the sACCF group.

Conclusions

sACCF with preservation of middle vertebrae is a safe, reliable, and effective alternative procedure for the treatment of 4-level CSM.

Phillips DG (1973) Surgical treatment of myelopathy with cervical spondylosis. J Neurol Neurosurg Psychiatry 36:879–884PubMedCentralPubMedCrossRef

Edwards CC 2nd, Riew KD, Anderson PA et al (2003) Cervical myelopathy: current diagnostic and treatment strategies. Spine J 3:68–81PubMedCrossRef

Mehdorn HM, Fritsch MJ, Stiller RU (2005) Treatment options and results in cervical myelopathy. Acta Neurochir Suppl 93:177–182PubMedCrossRef

Ghogawala Z, Coumans JV, Benzel EC et al (2007) Ventral versus dorsal decompression for cervical spondylotic myelopathy: surgeons’ assessment of eligibility for randomization in a proposed randomized controlled trial: results of a survey of the Cervical Spine Research Society. Spine 32:429–436PubMedCrossRef

Konya D, Ozgen S, Gercek A et al (2009) Outcomes for combined anterior and posterior surgical approaches for patients with multisegmental cervical spondylotic myelopathy. J Clin Neurosci 16:404–409PubMedCrossRef

Herkowitz HN (1988) A comparison of anterior cervical fusion, cervical laminectomy, and cervical laminoplasty for the surgical management of multiple level spondylotic radiculopathy. Spine 13:774–780PubMedCrossRef

Yonenobu K, Hosono N, Iwasaki M et al (1992) Laminoplasty versus subtotal corpectomy. A comparative study of results in multisegmental cervical spondylotic myelopathy. Spine 17:1281–1284PubMedCrossRef

Sakaura H, Hosono N, Mukai Y et al (2003) C5 palsy after decompression surgery for cervical myelopathy: review of the literature. Spine 28:2447–2451PubMedCrossRef

Kaptain GL, Simmons NE, Replogle RE et al (2000) Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg 93:199–204PubMedCrossRef

10.

Yalamanchili PK, Vives MJ, Chaudhary SB (2012) Cervical spondylotic myelopathy: factors in choosing the surgical approach. Adv Orthop 2012:783762PubMedCentralPubMedCrossRef

11.

Hirabayashi K, Bohlman HH (1995) Multilevel cervical spondylosis. Laminoplasty versus anterior decompression. Spine 20:1732–1734PubMedCrossRef

12.

King JT Jr, Roberts MS (2002) Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy. J Neurosurg 97:180–185PubMed

13.

Vernon H, Mior S (1991) The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 14:409–415PubMed

14.

Odom GL, Finney W, Woodhall B (1958) Cervical disk lesions. J Am Med Assoc 166:23–28PubMedCrossRef

15.

Yonenobu K, Abumi K, Nagata K et al (2001) Interobserver and intraobserver reliability of the Japanese Orthopedic Association scoring system for evaluation of cervical compression myelopathy. Spine 26:1890–1894 discussion 1895PubMedCrossRef

16.

Koller H, Hempfing A, Ferraris L et al (2007) 4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results. Eur Spine J 16:2055–2071PubMedCentralPubMedCrossRef

17.

Lin Q, Zhou X, Wang X et al (2012) A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy. Eur Spine J 21:474–481PubMedCentralPubMedCrossRef

18.

Sayana MK, Jamil H, Poynton A (2011) Cervical laminoplasty for multilevel cervical myelopathy. Adv Orthop 2011:241729PubMedCentralPubMedCrossRef

19.

Liu Y, Hou Y, Yang L et al (2012) Comparison of 3 reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy. Spine 37:E1450–E1458PubMedCrossRef

20.

Robinson RA, Smith GW (1955) Anterolateral cervical disc removal and interbody fusion for the cervical disc syndrome. Bull John Hopkins Hosp 96:223–224

21.

Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617PubMedCrossRef

22.

Singh K, Vaccaro AR, Kim JMS (2004) Enhancement of stability following anterior cervical corpectomy: a biomechanical study. Spine 29:845–849PubMedCrossRef

23.

Bulger RF, Rejowski JE, Beatty RA (1985) Vocal cord paralysis associated with anterior cervical fusion: considerations for prevention and treatment. J Neurosurg 62:657–661PubMedCrossRef

24.

Flynn TB (1982) Neurologic complications of anterior cervical interbody fusion. Spine 7:536–539PubMedCrossRef

25.

Frempong-Boadu A, Houten JK, Osborn B et al (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15:362–368PubMedCrossRef

26.

Kriskovich MD, Apfelbaum RI, Haller JR (2000) Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury. Laryngoscope 110:1467–1473PubMedCrossRef

27.

Dalbayrak S, Yilmaz M, Naderi S (2010) “Skip” corpectomy in the treatment of multilevel cervical spondylotic myelopathy and ossified posterior longitudinal ligament. J Neurosurg Spine 12:33–38PubMedCrossRef

28.

Yang HL, Chen GD, Zhang HT et al (2013) Open-door laminoplasty with plate fixation at alternating levels for treatment of multilevel degenerative cervical disease. J Spinal Disord Tech 26:E13–E18PubMedCrossRef

29.

Kimura A, Seichi A, Inoue H et al (2011) Long-term results of double-door laminoplasty using hydroxyapatite spacers in patients with compressive cervical myelopathy. Eur Spine J 20:1560–1566PubMedCentralPubMedCrossRef

30.

Woods BI, Hohl J, Lee J et al (2011) Laminoplasty versus laminectomy and fusion for multilevel cervical spondylotic myelopathy. Clin Orthop Relat Res 469:688–695PubMedCentralPubMedCrossRef

31.

Boakye M, Patil CG, Santarelli J et al (2008) Cervical spondylotic myelopathy: complications and outcomes after spinal fusion. Neurosurgery 62:455–461PubMedCrossRef

32.

Katsuura A, Hukuda S, Imanaka T et al (1996) Anterior cervical plate used in degenerative disease can maintain cervical lordosis. J Spinal Disord 9:470–476PubMedCrossRef

33.

Papadopoulos EC, Huang RC, Girardi FP et al (2006) Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Spine 31:897–902PubMedCrossRef

34.

Sevki K, Mehmet T, Ufuk T et al (2004) Results of surgical treatment for degenerative cervical myelopathy: anterior cervical corpectomy and stabilization. Spine 29:2493–2500PubMedCrossRef

35.

Hwang SL, Lin CL, Lieu AS et al (2004) Three-level and four-level anterior cervical discectomies and titanium cage-augmented fusion with and without plate fixation. J Neurosurg Spine 1:160–167PubMedCrossRef

36.

Flynn TB (1982) Neurologic complications of anterior cervical interbody fusion. Spine 7:536–539PubMedCrossRef

37.

38.

Kriskovich MD, Apfelbaum RI, Haller JR (2000) Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury. Laryngoscope 110:1467–1473PubMedCrossRef

39.

Apfelbaum RI, Kriskovich MD, Haller JR (2000) On the incidence, cause, and prevention of recurrent laryngeal nerve palsies during anterior cervical spine surgery. Spine 25:2906–2912PubMedCrossRef

40.

Mendoza-Lattes S, Clifford K, Bartelt R et al (2008) Dysphagia following anterior cervical arthrodesis is associated with continuous, strong retraction of the esophagus. J Bone Jt Surg Am 90:256–263CrossRef

41.

Kahraman S, Sirin S, Erdogan E et al (2007) Is dysphonia permanent or temporary after anterior cervical approach? Eur Spine J 16:2092–2095PubMedCentralPubMedCrossRef

42.

Wang JC, Hart RA, Emery SE et al (2003) Graft migration or displacement after multilevel cervical corpectomy and strut grafting. Spine 28:1016–1021 discussion 1021–1022PubMed

43.

Hilibrand AS, Fye MA, Emery SE et al (2002) Increased rate of arthrodesis with strut grafting after multilevel anterior cervical decompression. Spine 27:146–151PubMedCrossRef

44.

Nirala AP, Husain M, Vatsal DK (2004) A retrospective study of multiple interbody grafting and long segment strut grafting following multilevel anterior cervical decompression. Br J Neurosurg 18:227–232PubMedCrossRef

45.

Kawaguchi Y, Kanamori M, Ishiara H et al (2003) Preventive measures for axial symptoms following cervical laminoplasty. J Spinal Disord Tech 16:497–501PubMedCrossRef

46.

Sakaura H, Hosono N, Mukai Y et al (2010) Preservation of muscles attached to the C2 and C7 spinous processes rather than subaxial deep extensors reduces adverse effects after cervical laminoplasty. Spine 35:E782–E786PubMedCrossRef

47.

O’Toole JE, Olson TJ, Kaiser MG (2004) Surgical management of dissociated motor loss following complex cervical spine reconstruction. Spine 29:E56–E60PubMedCrossRef

Titel: Segmental anterior cervical corpectomy and fusion with preservation of middle vertebrae in the surgical management of 4-level cervical spondylotic myelopathy
verfasst von: Zhonghai Li
Zhenggang Guo
Shuxun Hou
Yantao Zhao
Hongbin Zhong
Shunzhi Yu
Tiesheng Hou
Publikationsdatum: 01.07.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 7/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3208-z

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