Anterior Segmental Decompression and Interbody Fusion for Multi-segmental Cervical Spondylotic Myelopathy in the Elderly

Abstract

To explore the clinical effect of anterior segmental decompression and interbody fusion in treatment of elderly patients with complex cervical spondylotic myelopathy of three segments or more, 50 patients, with titanium plate internal fixation bone fusion underwent anterior cervical decompression and multi segmental cervical spondylosis, were collected. Parameters of operation time, intraoperative blood loss, JOA score 1 week before and after, 12 months after operation, cervical X-ray, CT and MRI before and after operation were measured. Clinical symptoms and the improvement of JOA, internal fixation and bone grafting fusion, cervical standard sagittal Cobb angle, lateral fusion segment of vertebral body height (height of anterior border, HAB) and posterior height (height of posterior border, HPB), were observed. Operation time was 90 ~ 150 minutes, average 120 minutes. The amount of bleeding 150 ~ 450 ml, average 325.5 ml. Mean follow-up time was 15.1 months. 2 weeks after operation, sympathetic symptoms were improved obviously, lower limb muscle strength was increased, physical activity was significantly improved, and anesthesia of double upper limbs disappeared. Except for the 3 cases who had serious cervical spinal cord injury showed no obvious recovery, the other 47 patients showed significant improved neurological recovery. X-ray results of 12 months after operation showed that 50 cases of fused intervertebral, intervertebral height and lordosis maintained good. In general, anterior segmental decompression and bone graft fusion and titanium plate internal fixation operation is a safe and effective operation for treating the three section and above cervical spondylotic myelopathy, worth recommending.