Anterior Cervical Decompression and Fusion for the Treatment of Cervical Spondylotic Myelopathy

Abstract

Purpose : This study was designed to evaluate the suitability of anterior cervical decompression and fusion in the surgical treatment of cervical spondylotic myelopathy, and to analyze the factors influencing outcome. Materials and Methods : Twenty-six patients were reviewed with at least one year follow-up. Preoperative duration and severity of neurologic symptoms, Pavlov ratio and the anterior-posterior compression ratio of the spinal cord were assessed to analyze the prognostic factors affecting the treatment results. The Nurick and JOA scoring system was used to classify the severity of disability associated with the myelopathy before the operation and at the latest follow-up examination. Results : Though the duration of symptoms did not, the severity of pain did affect the prognosis (r=-0.500, p=0.009). The Pavlov ratio (r=-0.394, p=0.046) and the anterior-posterior compression ratio of the spinal cord were closely related to the preoperative and postoperative severity of myelopathy (r=-0.511, p=0.008). The average grade according to the Nurick system improved from 2.19 to 0.93, and the JOA score from 12.4 to 15.9. Conclusion : Anterior cervical decompression and fusion appears to be a reliable procedure in terms of neurological recovery, functional improvement, and pain relief in patients with cervical spondylotic myelopathy.