Short-Term Outcomes of Anterior Fusion-Nonfusion Hybrid Surgery versus Posterior Cervical Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy.

OBJECTIVE: To compare short-term clinical and radiologic outcomes of anterior fusion-nonfusion hybrid surgery (cervical discectomy or corpectomy and fusion combine with cervical disc replacement) and posterior cervical laminoplasty for multilevel cervical spondylotic myelopathy.

METHODS: From January 2014 to December 2015, 105 patients who underwent anterior fusion-nonfusion hybrid surgery (AHS group, n = 48) or posterior cervical laminoplasty (n = 57) for ≥3 disc levels cervical spondylotic myelopathy were included. The Japanese Orthopedic Association (JOA) score, complications, and radiologic results including cervical curvature and cervical range of motion (ROM) were compared between the 2 groups of patients. The complications that occurred within 1 month after the surgery were recorded as early complications, otherwise they were considered late complications.

RESULTS: Both groups gained significant JOA scores improvement (P < 0.05). No significant difference in JOA improvement was found between the 2 groups (P > 0.05). The cervical curvature increased significantly in the AHS group (P = 0.024), whereas it decreased significantly in the posterior cervical laminoplasty group (P = 0.002). Cervical ROM of both groups significantly decreased after the surgery (P < 0.05). The preoperative and final follow-up cervical ROM, together with the total cervical ROM preservation rate were not significant different between the 2 groups (P > 0.05). The AHS group had a significant higher early complication rate (22/48 vs. 15/57; P = 0.037) and a lower late complication rate (9/48 vs. 21/57; P = 0.041).

CONCLUSIONS: Both anterior fusion-nonfusion hybrid surgery and cervical laminoplasty could gain satisfied neurological recovery. The anterior hybrid surgery may preserve cervical curvature with a higher early complication rate and a lower late complication rate than cervical laminoplasty.