Anterior Versus Posterior Approach for Multilevel Cervical Spondylotic Myelopathy

Abstract

ackground Data: Cervical spondylotic myelopathy (CSM) is a common spinal d isorder that we face in daily clinical practice. Both anterior and posterior approaches alone or in combination with one another have been used to treat the condition. The ideal approach however is still not agreed on particularly when the levels involved are three or more. Purpose: We report our experience in managing multilevel CSM using both anterior and posterior approaches and compare the clinical and radiological outcome and also complications. Study Design: Retrospective analysis clinical case study. Patients and Methods: Forty-two patients who had surgery for multilevel CSM under our care were included in this study. We recorded the Visual Analogue Score (VAS) for neck pain, Nurick myelopathy score and cervical alignment (C2-C7 angle) on lateral X ray film preoperatively and on each follow up visit (3 weeks, 3, 6 and 12 months). We compared the results using Paired Student’s t-test was used for comparing paired data having entered all data into Paired Student’s t-test was used for comparing paired data. Results: There was a significant difference in myelopathy and neck pain improvement in both groups and significant improvement in cervical alignment in the anterior approach but not posterior approach group. Conclusion: Both anterior and posterior approaches significantly improve neck pain and myelopathy in patients with multilevel cervical spondylotic myelopathy although the anterior approach has the advantage of kyphotic angle correction. (2015ESJ076)

Keywords

• Cervical spondylotic myelopathy
• Laminectomy
• fusion
• corpectomy
• anterior cervical discectomy