Combined single-level subtotal corpectomy and decompression for cervical spondylotic myelopathy treatment

Background: The purpose of this study was to summarize outcomes of patients with refractory multisegmental cervical spondylotic myelopathy (CSM) who were treated by combined single-level subtotal corpectomy and decompression of the intervertebral space using the anterior approach. Methods: Forty-five consecutive patients with multisegmental CSM were included; their ages ranged from 37 to 72 years. Seventeen (37.8%) patients had noncontiguous or ` jumping' multisegmental CSM and 28 (62.2%) had contiguous multisegmental CSM. The mean preoperative Japanese Orthopedic Association (JOA) score was 8.1 points. All patients underwent combined single-level decompression of the involved intervertebral space and subtotal corpectomy together with subsequent fusion and internal fixation. An anterior approach was used for all patients. Acage filled with bone graft was inserted and internal fixation was performed after single-level intervertebral space decompression. Mesh filled with bone graft was inserted and plate internal fixation was performed after subtotal corpectomy. Results: Follow-up data (average follow-up, 14 months) were available for all 45 patients; the mean postoperative JOA score was 13.2 points, which was significantly different from the preoperative JOA score. Bony fusion was achieved in all patients based on postoperative radiography, and no pseudoarthrosis was observed during follow-up. Conclusions: An excellent outcome can be achieved with the combination of singlelevel subtotal corpectomy and decompression of the intervertebral space using the anterior approach to treat multisegmental CSM.