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Anterior hybrid decompression and segmental fixation for adjacent three-level cervical spondylosis
Qunfeng Guo1, Bin Ni, Fengjin Zhou
1Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, 200003 Shanghai, People's Republic of China.
Objective:
To evaluate the outcomes of anterior hybrid decompression and segmental fixation for adjacent three-level cervical spondylosis.
Methods:
53 patients with adjacent three-level cervical spondylosis underwent anterior hybrid decompression and segmental fixation. Titanium mesh and PEEK cage were used to span the defects due to decompression and anterior locking plate was placed over the entire construct. Japanese Orthopedic Association (JOA) scores, segmental and C2-C7 angles before and after operation were analyzed.
Results:
The average follow up was 37.3 ± 7.0 months. Bone fusions were observed in all patients at follow-up intervals. JOA scores improved from preoperative 8.1 ± 2.2 (range 4-13) to 13.1 ± 2.3 (range 7-16) at final follow-up (P = 0.000). Meanwhile, surgical segmental angle was significantly improved from preoperative 6.9 ± 8.3° (range -10.4° to 27.6°) to postoperative 16.3 ± 7.2° (range -2.0° to 37.6°)(P = 0.000), and C2-C7 angle from 9.7 ± 8.6° (range -9.9° to 27.4°) to 17.8 ± 7.7° (range -1.2° to 34.3°) (P = 0.000). Postoperative complications included C5 palsy, cerebrospinal fluid leakage, hematoma, and titanium mesh subsidence.
Conclusion:
Anterior hybrid decompression and segmental fixation is a safe and effective procedure for adjacent three-level cervical spondylosis.