Abstract
Introduction This is a retrospective comparative study that aims to compare the benefits of different surgical approaches for patients with multilevel cervical canal stenosis (CCS) without cervical fracture or dislocation of acute traumatic central cord syndrome (ATCCS). Methods From January 2015 to December 2018, 59 patients were included in the study. Among them, 35 patients (Group A) received anterior surgery and 24 patients (Group B) received posterior surgery. Primary outcome measures were American Spinal Cord Injury Association (Asia) grade, Japanese Orthopaedic Association (JOA) score, and recovery rate (RR). Secondary outcome measures included operation time, intraoperative blood loss, visual analogue scale (VAS) score, cervical sagittal parameters, and complications. Multivariate linear regression was used to analyze prognostic determinants. Results Compared with Group B, Group A had longer operation time and more intraoperative blood loss (P < 0.05). However, the VAS score of Group B was higher than that of Group A at discharge (P < 0.05). There was no significant difference in cervical sagittal plane parameters between the two groups (P > 0.05). Postoperative complications were different in the two groups. During follow-up, the Asia grade, the JOA score, and RR of both groups improved (P < 0.05), but there were no significant differences between the two groups (P > 0.05). Younger age, earlier surgery, and better preoperative Asia grade were correlated with better prognosis. Conclusions For patients with multilevel CCS without cervical fracture or dislocation of ATCCS, both surgical approaches had good outcomes. Although no significant differences were found in the primary outcome measures between the two groups, there were different recommendations for the secondary outcome measures. Younger age, earlier surgery, and better preoperative Asia grade were protective factors for better prognosis.
Highlights
Introduction. is is a retrospective comparative study that aims to compare the benefits of different surgical approaches for patients with multilevel cervical canal stenosis (CCS) without cervical fracture or dislocation of acute traumatic central cord syndrome (ATCCS)
No significant differences were found in the primary outcome measures between the two groups, there were different recommendations for the secondary outcome measures
Introduction e incidence of cervical spinal cord injury (SCI) due to acute trauma has been increasing year by year in the world [1], and one of the most common symptoms is acute traumatic central cord syndrome (ATCCS), which accounts for approximately 70% of all incomplete SCI [2,3,4,5]. is symptom was first proposed by Schneider in 1954, and its clinical manifestations are as follows: differential weakness of the upper and lower extremities and variable involvement of the sensory system and a variable impact on bladder function [6, 7]
Summary
Introduction. is is a retrospective comparative study that aims to compare the benefits of different surgical approaches for patients with multilevel cervical canal stenosis (CCS) without cervical fracture or dislocation of acute traumatic central cord syndrome (ATCCS). Is is a retrospective comparative study that aims to compare the benefits of different surgical approaches for patients with multilevel cervical canal stenosis (CCS) without cervical fracture or dislocation of acute traumatic central cord syndrome (ATCCS). For patients with multilevel CCS without cervical fracture or dislocation of ATCCS, both surgical approaches had good outcomes. Surgeons should choose the appropriate approach to decompress the spinal cord and pay close attention to try to restore the volume of the stenotic spinal canal When these patients have ossification of the posterior longitudinal ligament (OPLL), the anterior approach is usually contraindicated due to the presence of adherences between the dura and the ossified posterior ligament, with a high risk of central spinal fluid leak [17, 18]. We conducted a retrospective comparative study to compare the benefits of anterior and posterior surgical treatments for patients with multilevel CCS without cervical fracture or dislocation of ATCCS. We tried to analyze the factors that determine the prognosis of these patients
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