CERVICAL CORPECTOMY VERSUS TWO-LEVEL ANTERIOR DISCECTOMY FOR DOUBLE-LEVEL CERVICAL SPONDYLOTIC MYELOPATHY

Abstract

: Background : The recognized surgical procedures for cervical spondylotic myelopathy (CSM) include anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF). The best surgical technique for double-level CSM is still up for debate, though. Aim of the study: This study aimed to evaluate the postoperative clinical and radiological outcomes of the CSM patients who underwent two adjacent cervical discectomies versus a single-level corpectomy. Patients and Methods: In this retrospective cohort study, we reviewed the medical records of patients with double-level CSM at our university hospital. We included the data of the patients who underwent two adjacent ACDFs (group A) and the patients who underwent a single-level ACCF (group B) from January 2015 to December 2020. Thirty-five patients met our selection criteria. The functional impairment was assessed using the Nurick grades. Results: The study groups were similar in age, gender, and comorbidities. The mean operative time and the intraoperative blood loss were significantly lower in the ACDF group. There were no statistically significant differences in the clinical outcome of both groups. Also, there were no statistically significant differences between the two groups regarding the one-year incidence of bony fusion, the improvement in the degree of canal stenosis, or Cobb’s angle. In addition, the postoperative complications were similar between groups. Conclusions: From our results, we cannot recommend one procedure over the other for treating double-level CSM. However, ACDF carries a significantly shorter operative time with less blood loss than the ACCF procedure.