Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy

Abstract

Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: 96 patients with cervical spondylosis were randomly selected among all patients admitted in our hospital from January 2013 to December 2015. They were evenly assigned to A, B or C group, 32 patients each.  Patients in Group A suffered from cervical myelopathy and were treated by combined anterior and posterior approach. Patients in Group B group suffered from cervical vertebra disease and accepted a cervical corpectomy decompression and a bone graft fusion internal fixation surgery. Patients in Group C accepted conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: JOA scores of all three groups were improved after 6 months. After a year, patients in Group A, B and C scored (16.3 ± 1.83), (15.7 ± 1.15) and (15.59 ± 1.21), respectively. The pairwise score differences between any two groups were statistically significant (P < 0.05). After one year’s follow-up, the bone graft and internal fixation material had no signs of loosening, displacement or subsidence. The fusion rates of Group A, B and C reached 90.6%, 53.1% and 56.25%, respectively. Similarly, the pairwise differences in fusion rate between any two groups were statistically significant (P < 0.05). The clinical effectiveness was classified as apparent, effective, fair and invalid. The effective rates of Group A, B and C were 87.5%, 50% and 56.2%, respectively. The pairwise differences between any two groups were statistically significant (P < 0.05). Conclusion: Combined anterior and posterior approach surgery significantly improved the clinical efficacy than the other two surgeries.