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Two-level anterior cervical discectomy versus one-level corpectomy in cervical spondylotic myelopathy

 Min Chul Oh  ;  Ho Yeol Zhang  ;  Jeong Yoon Park  ;  Keun Su Kim 
 SPINE, Vol.34(7) : 692-696, 2009 
Journal Title
Issue Date
Adult ; Aged ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/pathology ; Cervical Vertebrae/surgery* ; Diskectomy/instrumentation ; Diskectomy/methods* ; Diskectomy/standards ; Female ; Humans ; Internal Fixators/standards ; Intervertebral Disc/diagnostic imaging ; Intervertebral Disc/pathology ; Intervertebral Disc/surgery ; Intervertebral Disc Displacement/complications ; Intervertebral Disc Displacement/pathology ; Intervertebral Disc Displacement/surgery* ; Length of Stay ; Male ; Middle Aged ; Neck Pain/etiology ; Neck Pain/physiopathology ; Neck Pain/surgery ; Outcome Assessment (Health Care)/methods ; Postoperative Complications/etiology ; Postoperative Complications/physiopathology ; Radiography ; Range of Motion, Articular/physiology ; Retrospective Studies ; Spinal Cord Compression/etiology ; Spinal Cord Compression/pathology ; Spinal Cord Compression/surgery* ; Spinal Fusion/instrumentation ; Spinal Fusion/methods ; Spinal Fusion/standards ; Spondylosis/complications ; Spondylosis/pathology ; Spondylosis/surgery* ; Treatment Outcome ; Vertebroplasty/instrumentation ; Vertebroplasty/methods* ; Vertebroplasty/standards
cervical spondylotic myelopathy ; anterior cervical discectomy and anterior interbody fusion ; anterior cervical corpectomy and anterior interbody fusion
STUDY DESIGN: A retrospective investigation of clinical and radiologic outcomes after surgical treatment for 2-level cervical spondylotic myelopathy (CSM). OBJECTIVE: The study was undertaken to compare the outcomes of 2 different anterior approach types for 2-level CSM. Specifically, 2-level anterior cervical discectomy and fusion (ACDF) was compared with 1-level anterior cervical corpectomy and fusion (ACCF). SUMMARY OF BACKGROUND DATA: The optimal surgical approach for 2-level CSM has not been defined, and thus, the relative merits of 2-level ACDF and 1-level ACCF remain controversial. However, few comparative studies have been conducted on these 2 surgical approaches. METHODS: The authors reviewed the case histories of 31 patients that underwent surgical treatment for 2-level CSM from 2002 to 2006. Cases of myelopathy because of cervical ossification of posterior longitudinal ligament were excluded. Thirty-one patients (16 men and 15 women) of mean age 54.45 +/- 11.6 years (28 approximately 77) were included. The average follow-up period was 26.23 +/- 15.0 months (12 approximately 63). The authors compared perioperative parameters (hospital stays, bleeding amounts, operation times, complications), clinical parameters (Japanese Orthopedic Association scores, Visual Analog Scale scores for neck and arm pain), and radiologic parameters (total cervical range of motion, segmental range of motion, segmental height, cervical lordosis, fusion rate). RESULTS: Of these above parameters, operation time (P = 0.001) and bleeding amount (P = 0.001) were significantly greater in the ACCF group, whereas segmental height (P = 0.018) and postoperative cervical lordosis (P = 0.009) were significantly lower in the ACCF group. However, other parameters were not significantly different in the 2 groups. CONCLUSION: Surgical managements of 2-level CSM using ACDF or ACCF were found to be similar in terms of clinical outcomes. However, 2-level ACDF was found to be superior to 1-level ACCF in terms of operation times, bleeding amounts, and radiologic resu
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
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