Anterior Cervical Decompression With Fusion For Treating Multilevel Cervical Myelopathy

Objective To evaluate the clinical value of the segemental methods of anterior cervical decompression with fusion for treating multilevel cervical myelopathy.Method From June 2003 to March 2006, a retrospective review of 47 patients who had undergone segemental method of anterior cervical decompression with fusion for treating multilevel cervical myelopathy, include 15 male,5 female ,aged from 47 years to 80 years with an average of 64.2 years ,whose course of disease ranged from 0.5 to 108 months(average 17.5 months).The vertebrae involved C₃ to C₆(6 cases),G to C₇(4 cases),C₃ to C₇(10 cases).Corpectomy was performed on C₄(10 cases),C₅(8 cases),C₆(8 cases),discectomy was performed on C_3-4(12 cases), C_4-5(20cases), C_5-6 (20 cases), G_6-7 (16cases). The intervertebral space include 3spaces(10 cases), 4 spaces(10 cases). All patiens' cervical plain films magnetic resonance imagings(MRI) and computed tomographies(CT) on preoperation and postoperation (within 3 days,1month,3 month,6 month,12 month) were observed . The mJOA(modified JOA) scores ,Nurick scores of preoperation and 3 month postoperatively were collected. The implant graft fusion rate ,the degree of correcting kyphotic deformity in cervical vertebrae and the complications were recorded.Results 20 cases were followed up from 12 months to 42 months,average 21.8 months. All patient improved their functional status in different degree. No complications such as graft dislocation,screwes and plates loosing or broken were happened. The mean preoperative mJOA score of all patients was 9.2±2.9,the postoperative wasl3.8±1.3,the average mJOA recovery rate was 59.4±6.4%(p<0.05);The mean preoperative Nurick score of all patients was 3.1±1.2, the postoperative was 0.6±0.5,the average Nurick recovery rate was 50±16.5%(p<0.05). The mean preoperative sagittal diameter of cervical canal was 4.3 ± 1.5mm,the postoperative was 6.5±1.1mm(p<0.05). The fusion time varied from 3 month to 8 month (average 3.6±1.5 month).All patients' kyphotic deformity was corrected and some restorednormally.Conclusion The segemental method of anterior cervical decompression with fusion for treating multilevel cervical myelopathy appears to be effectively decompressing spinal cord,improving nerve functional status and restoring lordosis to the cervical spine with high fusion rate and lower complications.