scholarly journals Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion in multilevel cervical spondylotic myelopathy

Medicine ◽  
2016 ◽  
Vol 95 (49) ◽  
pp. e5437 ◽  
Author(s):  
Tao Wang ◽  
Hui Wang ◽  
Sen Liu ◽  
Huang-Da An ◽  
Huan Liu ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Cervical Corpectomy ◽  
Multilevel Cervical Spondylotic Myelopathy ◽  
Anterior Cervical Corpectomy

scholarly journals Efficacy and Safety of Surgical Interventions for Treating Multilevel Cervical Spondylotic Myelopathy via Anterior Approach: A Network Meta-Analysis

2019 ◽  
Vol 4 (22;4) ◽  
pp. E275-E285
Author(s):  
Bo Li
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Meta Analysis ◽  
Total Disc Replacement ◽  
Anterior Cervical Discectomy ◽  
Hybrid Surgery ◽  
Cervical Total Disc Replacement ◽  
Cervical Discectomy ◽  
Total Incidence ◽  
Multilevel Cervical Spondylotic Myelopathy ◽  
Anterior Cervical Corpectomy

Background: Anterior cervical discectomy, with or without interbody fusion, is a common technique to treat cervical spondylotic myelopathy (CSM). To date, controversy still exists among spine surgeons regarding the anterior surgical approach to be used for the treatment of multilevel CSM. Objectives: To evaluate the effectiveness and safety of anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), cervical total disc replacement (CTDR), and hybrid surgery (HS) in the treatment of multilevel CSM. Study Design: Network meta-analysis (NMA) of randomized or nonrandomized controlled studies for the treatment of multilevel CSM. Methods: The databases such as PubMed, CENTRAL, and EMBASE were used to search and identify the clinical trials involving the evaluations for the treatment of multilevel CSM. The Newcastle-Ottawa Scale was used for the assessment of methodological qualities, whereas the Cochrane Collaboration tool was used for assessing the risk of bias. Outcome assessments included duration of surgery, Neck Disability Index (NDI) scores, and complications. Odds ratio was used to express dichotomous outcomes, whereas mean difference with a 95% confidence interval was used to express continuous outcomes. Results: Sixteen relevant studies were identified, and 1,639 patients were included in this analysis. CTDR demonstrated a prominently decreased NDI score and total incidence of complications compared with ACDF, ACCF, and HS. In addition, ACDF resulted in shorter operation times compared with ACCF, CTDR, and HS. The ranked order of NDI score improvement in decreasing order was: CTDR, HS, ACDF, followed by ACCF. The rank order for reduction in operation time increased progressively from ACDF, HS, ACCF to CTDR. The total incidence of complications also showed a decreasing trend in the decreasing order— CTDR, ACDF, HS, ACCF, and finally CTDR with the lowest complication rate. Limitations: The limitations of this NMA include inconformity of the follow-up times and surgical skill, and implants of different treatment centers vary. Conclusions: The analysis of this study has shown that the best method for improvement of functional outcome and reduction in total incidence of complications for multilevel CSM is CTDR. Key words: Multilevel cervical spondylotic myelopathy, anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, cervical total disc replacement, hybrid surgery, effectiveness, safety, network meta-analysis

scholarly journals Comparison study of clinical outcomes and sagittal alignment improvement between anterior and posterior fusion techniques for multilevel cervical spondylotic myelopathy

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098817
Author(s):  
Hui Liu ◽  
Xiang Li ◽  
Jianru Wang ◽  
Zemin Li ◽  
Zihao Li ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Sagittal Alignment ◽  
Vertical Axis ◽  
Anterior Cervical Discectomy ◽  
Sagittal Vertical Axis ◽  
Cervical Discectomy ◽  
Cervical Corpectomy ◽  
C7 Slope ◽  
Anterior Cervical Corpectomy

Purpose: To compare the sagittal alignment of different surgical approaches in patients with multiple levels cervical spondylotic myelopathy and explore the relationship between the cervical sagittal alignment and patient’s health relative quality of life. Method: A total of 97 multiple levels cervical spondylotic myelopathy patients who underwent surgery from January 2013 to January 2019 were collected in this study. Patients were divided into three groups: anterior cervical discectomy with fusion, anterior cervical corpectomy with fusion and laminectomy with fusion groups. Clinical outcomes and sagittal alignment parameters were compared preoperative and postoperative. Results: There were no significant differences in the average age and sex ratio among the groups. Sagittal parameters correlated to health relative quality of life were C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis. Both anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion groups exhibited better sagittal alignment and clinical outcomes improvement postoperatively. Anterior cervical discectomy with fusion provided better clinical outcomes and the better improvement of cervical lordosis, C7 slope, occipito-C2 angle and cervical sagittal vertical axis compared with patients with Laminectomy with fusion. Conclusion: C7 slope, occipito-C2 angle, external auditory meatus tilt and cervical sagittal vertical axis are the most important cervical sagittal parameters correlated to clinical outcomes in patients with multilevels cervical spondylotic myelopathy; anterior cervical discectomy with fusion and anterior cervical corpectomy with fusion provides more efficient to restoration of cervical sagittal alignment.

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