Observation of curative effects of one-stage combined posteroanterior approach for cervical spondylotic myelopathy in elderly patients
HUANG Wei
SHANG Wei-lin
BU Guo-yun
CAO Zheng
WU Wen-wen
HOU Shu-xun
Abstract：Objective To investigate the curative effects of one-stage combined posteroanterior approach for cervical spondylotic myelopathy ( CSM ) in elderly patients. Methods The data of 35 elderly patients who underwent one-stage combined posteroanterior approach for CSM in our institute from January 2008 to January 2011 were retrospectively analyzed. The Japanese Orthopedic Association ( JOA ) score and Nurick grading were employed to evaluate the neurological status of patients before and after the surgery. Single open-door laminoplasty was used in the posterior approach, and meanwhile interbody fusion with cage after discectomy or with titanium mesh cage after corpectomy were used in the anterior approach. Results All 35 patients were followed up for a mean duration of 18 months. Corpectomy was performed in 8 cases, interbody fusion with cage after single-segment discectomy in 17 cases and interbody fusion with cage after double-segment discectomy in 10 cases. The mean duration of operation was 245 min ( range;180-300 min ). The amount of blood loss was 505 ml on average ( range;100-1600 ml ). The JOA scores were ( 9.34±2.40 ) points and ( 13.11±1.90 ) points before and after the surgery respectively, and the mean improvement rate was 47%, with statistical differences between them. Except for 1 patient of grade V according to the Nurick grading system, all other patients had an improvement from grade I to grade III. Anterior interbody fusion occurred in all cases in 4-9 months postoperatively, without displacement or subsidence of the prostheses. The CT reexamination was performed in 25 cases during the follow-up, which revealed that no posterior reclosing occurred. And the cervical MRI was performed in 30 cases postoperatively, which showed that the spine cord was decompressed thoroughly. The postoperative complications were odynophagia in 8 cases, transient neurological deifcits in 3 cases, hoarseness in 1 case, deep venous thrombosis in 1 case and posterior incision infection in 1 case. Conclusions Elderly patients with CSM usually have many systemic diseases and a lot of postoperative complications. One-stage combined posteroanterior approach for CSM in elderly patients is an effective surgical method.
Keywords：Cervical spondylosisDiskectomySurgical proceduresOperativeAged
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 650-654 )