gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Comparison of ventral corpectomy and plate-screw-instrumented fusion with dorsal laminectomy and rod-screw-instrumented fusion for treatment of at least two-vertebral-level spondylotic cervical myelopathy

Meeting Abstract

  • R. Kristof - Neurochirurgische Klinik, Universitätsklinikum Bonn
  • T. Kiefer - Neurochirurgische Klinik, Universitätsklinikum Bonn
  • F. Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar der TU München
  • C. Mueller - Neurochirurgische Klinik, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.09-07

DOI: 10.3205/09dgnc059, URN: urn:nbn:de:0183-09dgnc0592

Published: May 20, 2009

© 2009 Kristof et al.
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Outline

Text

Objective: To verify the hypothesis that dorsal multilevel laminectomy and rod-screw-instrumented fusion (DLF) for multilevel spondylotic cervical myelopathy (MSCM) is less strenuous for patients, and less prone to perioperative complications than ventral multilevel corpectomy and plate-screw-instrumented fusion (VCF), while clinical outcome is comparable.

Methods: One hundred and three successive patients were treated for at least two-vertebral-level MSCM, 42 of them by VCF, and 61 by DLF. The two patient groups were retrospectively compared.

Results: VCF-patients were slightly younger than DLF-patients (62.5±10.61 years vs. 66±12.4 years, p=0.012). In VCF-patients a median of 2 (2-3) corpectomies and in DLF-patients a median of 3 (2-5) laminectomies were performed. In VCF-patients, surgery lasted longer than in DLF-patients (229±60 min. vs. 183±46 min., p≤0.001). Between the VCF- and the DLF-patients’ groups, no significant difference was found in perioperative complications (e.g. hardware failure rates of 16.7% in VCF-, and of 6.6% in the DLF-patients) and mortality rates. The postoperative outcome, as assessed by the postoperative change of the Nurick-scores and the patients’ satisfaction, did not differ between the two patients groups. However, when comparing the postoperative Nurick-scores directly, VCF-patients fared somewhat better than DLF-patients (median of 2 (0-5) vs. 3 (1-5), p=0.003

Conclusions: The hypothesized advantages of DLF over VCF in the surgical treatment of at least two-vertebral-level MSCM could not be confirmed in this retrospective study. A prospective randomized study is warranted to clarify this issue.