Anterior Controllable Antedisplacement Fusion for Multilevel Cervical Spondylotic Myelopathy with Spinal Stenosis: Comparison with Anterior Cervical Corpectomy and Fusion

Abstract

To introduce anterior controllable antedisplacement fusion (ACAF), a new surgical technique, to treat multilevel cervical spondylotic myelopathy with spinal stenosis and compare ACAF with anterior cervical corpectomy and fusion (ACCF). Patients with multilevel cervical spondylotic myelopathy with spinal stenosis who underwent ACAF (36 cases) and ACCF (45 cases) from January 2016 to June 2017 were enrolled in this study. Japanese Orthopaedic Association score was analyzed before the operation and at each scheduled follow-up during the follow-up period after surgery to evaluate neurologic function. Clinical and radiologic outcomes and perioperative complications were analyzed. At the final follow-up, mean Japanese Orthopaedic Association scores of the 2 groups were significantly improved compared with preoperatively (P < 0.01 and P < 0.01). However, mean Japanese Orthopaedic Association scores between the 2 groups were not statistically significant (13.7 ± 1.9 vs. 13.5 ± 1.8, P= 0.66). Operative duration was longer and blood loss was greater in the ACAF group compared with the ACCF group. Overall occurrence of complications in the ACAF group wassignificantly lower compared with the ACCF group (P< 0.05). ACAF has similar clinical and radiologic outcomes and fewer complications compared with ACCF in treatment of multilevel cervical spondylotic myelopathy with spinal stenosis. ACAF can be used as an alternative treatment for cervical stenosis.