Anterior cervical corpectomy for cervical spondylotic myelopathy: Experience and surgical results in a series of 70 consecutive patients

Chibbaro, Salvatore; Benvenuti, L.; Carnesecchi, S.; Marsella, M.; Pulerà, Flavio; Serino, D.; Gagliardi, Rolando

doi:10.1016/j.jocn.2005.04.011

Cited by 60 publications

(56 citation statements)

References 39 publications

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“…However, when clinical outcome was assessed by the presence of neck pain and patients satisfaction, there was no difference between VCF and DLF patients. Thus, these results are in accordance with the literature, where the clinical outcome of the two treatment modalities is considered to be comparable [2,4,19,25,27]. Notably, in the long-term follow-up, laminoplasties are thought to be more often associated with axial pain than VCF [7,13,25].…”

Section: Discussionsupporting

confidence: 90%

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

et al. 2009

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The objective of the article is to verify the hypothesis that the dorsal multilevel laminectomy and rodscrew-instrumented fusion (DLF) for multilevel spondylotic cervical myelopathy (MSCM) is less strenuous for patients, and less prone to perioperative complications, than ventral multilevel corpectomy and plate-screwinstrumented fusion (VCF), while clinical outcome is comparable. One hundred and three successive patients were treated for at least two vertebral-level MSCM, 42 of them by VCF and 61 by DLF. The two patients groups were retrospectively compared. VCF patients were slightly younger than DLF patients (62.5 ± 10.61 years versus 66 ± 12.4 years, P = 0.012). In VCF patients, a median of 2 (2-3) corpectomies and in DLF patients a median of 3 (2-5) laminectomies were performed. In VCF patients, surgery lasted longer than in DLF patients (229 ± 60 min versus 183 ± 46 min, P B 0.001). Between the VCF and the DLF patients groups, no significant difference was found in perioperative complications (e.g. hardware failure rates of 16.7% in VCF and of 6.6% in the DLF patients) and mortality rates. The postoperative outcome, as assessed by the postoperative change of the Nurick scores, the change of neck pain, the patients' satisfaction, and the change of the subaxial Cobb angle of the spine did not differ between the two patients groups. However, when comparing the postoperative Nurick scores directly, VCF patients fared somewhat better than DLF patients [median of 2 (0-5) versus 3 (1-5), P = 0.003]. The hypothesized advantages of DLF over VCF in the surgical treatment of at least two vertebral-level MSCM could not be confirmed in this retrospective study. A prospective randomized study is warranted to clarify this issue.

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Section: Discussionsupporting

confidence: 90%

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

et al. 2009

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“…Recently anterior cervical corpectomy has been introduced for the treatment of patients with multilevel degenerative cervical myelopathy [2,3]. Several studies reported that anterior cervical corpectomy and fusion was an affective procedure with a more favorable neurological improvement when compared to posterior decompressive laminectomy or laminoplasty [4,12]. It also seems to be a safe procedure even in the elderly population [4].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported that anterior cervical corpectomy and fusion was an affective procedure with a more favorable neurological improvement when compared to posterior decompressive laminectomy or laminoplasty [4,12]. It also seems to be a safe procedure even in the elderly population [4]. We prefer the anterior corpectomy and fusion as a first-line procedure in the aged patients because it can remove almost all pathology causing spinal cord compression like osteophytes, discs, and ossified PLL (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…However, the incidence of surgical relatedbecause of the complicated pathological changes of the spine and the increased presence of comorbidities. Recently anterior cervical corpectomy, titanium mesh cage (TMC) supporting and anterior cervical plate fixation has become a widely used surgical procedure for the treatment of multilevel cervical spondylotic myelopathy [2][3][4]. It has also been regarded as a safe procedure even in the elderly population [4].…”

mentioning

confidence: 99%

“…Recently anterior cervical corpectomy, titanium mesh cage (TMC) supporting and anterior cervical plate fixation has become a widely used surgical procedure for the treatment of multilevel cervical spondylotic myelopathy [2][3][4]. It has also been regarded as a safe procedure even in the elderly population [4]. However, to date, there have been few reports on the pathomechanism of cervical myelopathy in aged patients.…”

mentioning

confidence: 99%

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Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

Lü

et al. 2007

Eur Spine J

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Retrospective study on the results of anterior corpectomy for the treatment of cervical myelopathy in patients over 70 years old. To evaluate the surgical results of anterior corpectomy in aged patients with multilevel cervical myelopathy and to investigate the probable pathomechanism by radiographic study. There are few data focused on the surgical results and post-operative complications of anterior corpectomy in aged patients with cervical myelopathy. Twenty patients 70 years of age or older who underwent anterior corpectomy, titanium mesh cage (TMC) reconstruction and anterior plate fixation for the treatment of compressive cervical myelopathy were reviewed. The average age at the time of operation was 75 years. Neurologic deficits before and after surgery were assessed using a scoring system proposed by the Japanese Orthopedic Association (JOA Score). Clinical results and post-operative complications were compared with those of patients 69 years old or younger as a control. Pre-operative Radiologic evaluation of every patient consisted of anterior-posterior, lateral, bilateral oblique, flextion, and extension radiographs, computed tomography and magnetic resonance imaging of the cervical spine. Any factor causing spinal cord compression and the sign of cervical instability were recorded. Surgical-related complications occurred in seven patients in the aged group. The incidence of complications was 35% in the aged patient group and 9.7% in the control group respectively. Although the difference was striking, no statistical significance was found between the two groups. One patient died of respiratory failure resulting from pulmonary infection. The mortality rate was 5%. The pre-operative mean JOA score was 9.3 (from 3 to 14) in the aged patient group. Nineteen patients were followed at least 2 years and the mean JOA score was 13.4 (from 8 to 17). 68.4% of the aged patients achieved a good or excellent result. There was no statistical difference in the recovery rate of JOA score between the aged group (58.1%) and control group (67.0%). In the pre-operative radiographs, the incidence of cervical instability was much higher in the control group (32%) than in the aged group (5%) and multilevel cord compression caused by posterior disc space osteophytes was more common in the aged group. Anterior corpectomy combined with TMC fusion and plate fixation provides favorable neurologic recovery even in the patients over 70 years old. However, the incidence of surgical related complications shows a conspicuous increasing in the aged patients. Overcompensation mechanism for cervical instability is the probable cause of degenerative cervical spondylotic myelopathy in aged patients.

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The Oblique Corpectomy, Forgotten but an Effective Procedure? A Systematic Review

Souza

Broekema

Kuijlen

2019

Evidence for Neurosurgery

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Anterior cervical corpectomy for cervical spondylotic myelopathy: Experience and surgical results in a series of 70 consecutive patients

Cited by 60 publications

References 39 publications

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two vertebral-level spondylotic cervical myelopathy

Surgical results of anterior corpectomy in the aged patients with cervical myelopathy

The Oblique Corpectomy, Forgotten but an Effective Procedure? A Systematic Review

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