Surgical Result of the Combined Anterior and Posterior Approach in Treatment of Cervical Spondylotic Myelopathy.
- Author:
Jung Goan KIM
1
;
Seok Won KIM
;
Seung Myung LEE
;
Ho SHIN
Author Information
1. Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea. chosunns@hanmail.net
- Publication Type:Original Article
- Keywords:
Combined anterior and posterior approach;
Myelopathy;
Narrow spinal canal
- MeSH:
Animals;
Asian Continental Ancestry Group;
Decompression;
Follow-Up Studies;
Humans;
Lordosis;
Neck;
Pathology;
Postoperative Complications;
Radiography;
Spinal Canal;
Spinal Cord;
Spinal Cord Diseases*
- From:Journal of Korean Neurosurgical Society
2006;39(3):188-191
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study is to evaluate the efficacy and necessity of combined anterior approach (discectomy and fusion) and posterior approach(open-door laminoplasty) in the treatment of cervical spondylotic myelopathy. METHODS: The authors reviewed 14 cases in whom combined anterior and posterior approach performed for cervical myelopathy due to simultaneous anterior and posterior pathology such as huge central disc herniation with narrow spinal canal between January 2000 and December 2002. Clinical symptoms were evaluated by Japanese Orthopaedic Association (JOA) score and then the cervical curvature, change of spinal canal to vertebral body(SC/VB) ratio and canal widening were measured and compared to the clinical symptoms. RESULTS: The mean JOA score increased from 10.4+/-3.1 preoperatively to 14.8+/-1.2 at the final follow up with a mean recovery rate 66.4%. In all cases, there were not neurologic deterioration. Mild postoperative complications developed in two cases. One patient had a limitation of range of neck motion and the other one showed kyphotic change. Postoperative radiography showed an improvement of body to canal ratios (average 0.70+/-0.08 before surgery to 1.05+/-0.12 after surgery) and mainte nance or recovery of cervical lordosis. Canal widening of antero-posterior diameter and dimension after operation is 6.8 mm, 116.61 mm2. CONCLUSION: Combined anterior and posterior procedure could be helpful in decompression of the spinal cord and good functional recovery in spondylotic myelopathy patients with combined anterior and posterior pathology such as huge disc herniation accompanying narrow spinal canal.
