Long term results of anterior corpectomy and fusion for cervical spondylotic myelopathy

Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and rad...

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Bibliographic Details
Published in:PloS one 2012-04, Vol.7 (4), p.e34811-e34811
Main Authors: Gao, Rui, Yang, Lili, Chen, Huajiang, Liu, Yang, Liang, Lei, Yuan, Wen
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Alignment
Central nervous system diseases
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - surgery
Family medical history
Female
Females
Hospitals
Human papillomavirus
Humans
Male
Males
Medical imaging
Medicine
Middle Aged
Multivariate analysis
Neurosurgery
NMR
Nuclear magnetic resonance
Patients
Radiography
Recovery
Regression analysis
Retrospective Studies
Spinal cord
Spinal Cord Diseases - diagnostic imaging
Spinal Cord Diseases - surgery
Spinal Fusion
Spine
Spine (cervical)
Spondylosis - diagnostic imaging
Spondylosis - surgery
Surgeons
Surgery
Surgical outcomes
Treatment Outcome
X rays
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Summary:Results showed good clinical outcomes of anterior corpectomy and fusion (ACCF) for patients with cervical spondylotic myelopathy (CSM) during a short term follow-up; however, studies assessing long term results are relatively scarce. In this study we intended to assess the long term clinical and radiographic outcomes, find out the factors that may affect the long term clinical outcome and evaluate the incidence of adjacent segment disease (ASD). This is a retrospective study of 145 consecutive CSM patients on ACCF treatment with a minimum follow-up of 5 years. Clinical data were collected from medical and operative records. Patients were evaluated by using the Japanese Orthopedic Association (JOA) scoring system preoperatively and during the follow-up. X-rays results of cervical spine were obtained from all patients. Correlations between the long term clinical outcome and various factors were also analyzed. Ninety-three males and fifty-two females completed the follow-up. The mean age at operation was 51.0 years, and the mean follow-up period was 102.1 months. Both postoperative sagittal segmental alignment (SSA) and the sagittal alignment of the whole cervical spine (SACS) increased significantly in terms of cervical lordosis. The mean increase of JOA was 3.8 ± 1.3 postoperatively, and the overall recovery rate was 62.5%. Logistic regression analysis showed that preoperative duration of symptoms >12 months, high-intensity signal in spinal cord and preoperative JOA score ≤ 9 were important predictors of the fair recovery rate (≤ 50%). Repeated surgery due to ASD was performed in 7 (4.8%) cases. ACCF with anterior plate fixation is a reliable and effective method for treating CSM in terms of JOA score and the recovery rate. The correction of cervical alignment and the repeated surgery rate for ASD are also considered to be satisfactory.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0034811