Comparison Of Clinical Outcome Between Anterior And Posterior Approach For The Treatment Of Cervical Spondylotic Myelopathy(CSM)

Purpose: The Purpose of this study is to compare the clinical outcome between anterior and posterior surgical approach for the treatment of cervical spondylotic myelopathy(CSM).Study Design: A Prospective observational study Method: A total of 67 patients from the Second Affiliated Hospital of Dalian Medical University,Dalian,China from Orthopaedics(Spine)surgery department received anterior/posterior approach surgery depending upon surgeon’s choice.The modified Japanese Orthopedic Assessment Score(mJOAs),Nurick score and Visual Analogous Score(VAS)were used to evaluate the clinical outcomes.Age,Sex,duration of symptoms,Number of segments involved,Operative time,length of stay and intraoperation blood loss in hospital were also assessed.Result: Thirty seven patients were treated anteriorly and 30 underwent posterior approach surgery.Anterior approach cases were younger(51.51 vs.61.43)and were less severely involved as evaluated by mJOAs(13.08 vs.11.50)and Nurick Score(2.21 vs.2.58)then posterior approach.mJOA score,Nurick score and VAS,all showed significant improvement after surgery in both approaches(P < 0.05),but,while comparing both approaches no significant difference was found between the two approaches(P > 0.05).Perioperative parameters i.e.operative time,length of stay in hospital and intraoperation blood loss showed no significant difference statistically(P > 0.05)between the two approaches.The duration of symptoms and number of segment involvement also showed that the two approaches were not different in statistical terms(P > 0.05)between the two approaches.Conclusion: Patient with CSM showed significant improvement in clinical outcome evaluated with either anterior or posterior approach.Patients operated with anterior approach were younger and were less severely involved.We determined that anterior and posterior surgical approach have equal efficaciousness in the treatment of CSM.