Department of Orthopedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Department of Orthopedics, Shenzhen University General Hospital, Shenzhen, Guangdong Province, China.
World Neurosurg. 2019 Dec;132:e274-e282. doi: 10.1016/j.wneu.2019.08.178. Epub 2019 Sep 3.
To compare the change in cervical range of motion (CROM) after the 2 most widely used techniques for multilevel cervical spondylotic myelopathy (CSM): anterior cervical corpectomy and fusion (ACCF) and laminoplasty.
Patients with multilevel CSM treated in our hospital between 2014 and 2018 were divided into an ACCF group and a laminoplasty (LAMP) group according to the treatment received. Their demographic data, preoperative and postoperative Japanese Orthopedic Association (JOA) scores, and CROM, measured using the Coda Motion system, were analyzed and compared.
A total of 53 patients were enrolled, including 29 patients in the ACCF group and 24 patients in the LAMP group. Age, sex, duration of follow-up, and preoperative and postoperative JOA scores were comparable in the 2 groups. Compared with preoperative measurements, ACCF group lost an average of 9.8%, 28.5%, 8.9%, 9.9%, 10.6%, and 7.8% of their CROM in flexion, extension, left and right lateral flexion, and left and right rotation, respectively, at the latest follow-up. For the LAMP group, these average losses were 3.5%, 16.4%, 3.2%, 6.3%, 7.0%, and 5.7%, respectively. Thus, the ACCF group exhibited greater average CROM loss than the LAMP group in all directions at the latest follow-up.
Both ACCF and laminoplasty cause significant CROM loss in patients with multilevel CSM. The laminoplasty technique preserved more CROM than ACCF in all 6 directions after at least 1 year of follow-up. These results can be used when counseling patients undergoing surgery.
比较两种最常用于多节段颈椎病（CSM）的手术方法（前路颈椎椎体切除术和融合术 [ACCF] 和椎板成形术）后颈椎活动范围（CROM）的变化。
根据治疗方法，将 2014 年至 2018 年在我院治疗的多节段 CSM 患者分为 ACCF 组和椎板成形术（LAMP）组。分析比较了两组患者的人口统计学数据、术前和术后日本矫形协会（JOA）评分以及使用 Coda Motion 系统测量的 CROM。
共纳入 53 例患者，其中 ACCF 组 29 例，LAMP 组 24 例。两组患者的年龄、性别、随访时间、术前和术后 JOA 评分均无差异。与术前相比，ACCF 组在末次随访时屈伸、左右侧屈、左右旋转的 CROM 分别平均丧失 9.8%、28.5%、8.9%、9.9%、10.6%和 7.8%。LAMP 组的平均损失分别为 3.5%、16.4%、3.2%、6.3%、7.0%和 5.7%。因此，与 LAMP 组相比，ACCF 组在末次随访时各方向的 CROM 平均丧失更大。
ACCF 和椎板成形术都会导致多节段 CSM 患者的 CROM 显著丧失。在至少 1 年的随访后，椎板成形术在所有 6 个方向上保留的 CROM 均多于 ACCF。这些结果可用于手术患者的咨询。
