Abstract:

BACKGROUND: Anterior decompression and internal fixation for treatment of cervical spondylotic myelopathy has been widely accepted. However, there are few clinical case reports regarding this.
OBJECTIVE: To investigate the curative efficacy of anterior cervical decompression combined with bone grafting and titanium plate internal fixation in treatment of cervical spondylotic myelopathy. 
METHODS: A total of 118 patients with cervical spondylotic myelopathy who underwent anterior cervical subtotal vertebrectomy, iliac bone grafting (or bone grafting with titanium cage) and anterior locking titanium plate internal fixation at the Department of Orthopedics, Huang Gang Central Hospital of Hubei Province between January 2001 and August 2007 were retrospectively analyzed. According to the X-ray photographs taken before, immediately after surgery and during postoperative follow-up periods, Cobb’s angle, anterior vertebral height and posterior vertebral height of fused segments. Bone graft fusion was evaluated. Neurological function was assessed according to Japanese Orthopaedic Association (JOA) scores.
RESULTS: During the follow-up period (6-32 months, mean 19 months), three patients presented with slight titanium mesh sinking, and no fragmentation or loosening during internal fixation was observed in all patients, with a final bone fusion rate of 100%. JOA scores obtained immediately after surgery and during last follow-up were significantly greater compared with those obtained prior to surgery (P < 0.05). The excellent and good rate of neurological function recovery during the last follow-up was 86.2%. After surgery, sagittal Cobb’s angle, anterior and posterior vertebral heights of fused segments were significantly improved (P < 0.05). These findings indicate that anterior cervical subtotal decompression combined with bone grafting and titanium plate internal fixation for treatment of cervical spondylotic myelopathy can thoroughly decompress, effectively correct cervical vertebrae malformation, and achieve stable bone fusion and reconstruction, with satisfactory clinical efficacy.