Cervical spondylotic myelopathy treated by anterior multilevel decompression and fusion. Follow-up report of 214 cases.

ABSTRACT

From 1974 to 1982, 214 patients were treated for cervical spondylotic myelopathy by anterior multilevel decompression and the Robinson anterior interbody fusion and followed for an average of three years and 11 months. Postoperative results were superior to those obtained previously using posterior decompression. The average patient age was 50.1 years (range, 30-75); there were 187 men and 27 women. Overall, the percent of patients with excellent and good results was 59.3%; with fair results, 29%, no change; 7.9%, and deterioration, 3.8%. Of the 111 patients who had the disease less than one year before treatment, 74% were categorized after surgery as excellent or good. In contrast, only 36% of the 66 patients who had the disease more than two years were rated excellent and good. Myelography is valuable in diagnosing and locating lesions. The average number of discs removed was 3.1 per patient. The number of cases with excellent and good results was the same whether or not union of the graft occurred. Reoperation was required in 12 patients, and a third operation was performed in three patients. Eventually, 93% of the patients were able to lead independent lives.