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Corresponding Author

Emad H Abouelmmaty

Subject Area

Cervical spine, Degenerative

Document Type

Original Study

Abstract

Background Data: The best surgical approach for managing degenerative cervical myelopathy (DCM) remains debatable. Any surgical intervention for DCM aims to provide adequate neural elements decompression and preserve mechanical stability with the least morbidity and the best long-term outcome. Due to the heterogeneous nature of DCM, multiple approaches and interventions can be utilized.

Purpose: This study aims to compare the anterior cervical discectomy with fusion (ACDF) and posterior laminectomy with and without lateral mass fixation in (LMF) in the treatment of DCM regarding radiological and clinical outcomes.

Study Design: This is a retrospective case series study.

Patients and Methods: Twenty patients who underwent ACDF and 20 patients who underwent cervical laminectomy with and without LMF were reported in this study. Modified Japanese Orthopedic Association (mJOA) score and Myelopathy Scale (MS) were used for clinical assessment. Postoperative complications, recovery rate, and operative blood loss are recorded. The cervical curve and canal diameter were assessed.

Results: A total of 40 patients were reported in this study, including 33 males and 7 females, with a mean age of 58.8 ± 10.27 years. There was a significant improvement in cervical angle in the anterior group (19.38 ± 3.5 vs.16.5 ± 6.4, P = 0.043) and canal diameter in the posterior group versus (9.5 ± 0.76 vs.11.1 ± 1.98, P = 0.01). There were no significant differences between both groups on the mJOA scale (13.5 ± 4.16 vs.12.1 ± 1.7, P = 0.197), MS scale (5.1 ± 1.6 vs. 5.5 ± 1.07, P = 0.341), and complication rate (P value = 0.14).

Conclusion: Our data suggest that both anterior and posterior approaches were equivalent in treating DCM. Each case should be evaluated carefully to determine the best surgical approach.

Keywords

Degenerative cervical myelopathy, Anterior cervical discectomy and fusion, Cervical laminectomy, Lateral mass fixation

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