Extensive anterior decompression for mixed cervical spondylosis. Resection of uncovertebral joints, neural and transverse foraminotomy, subtotal corpectomy, and fusion with strut graft.

Abstract

This study examined a new operative procedure for treating mixed cervical spondylosis. To relate postoperative results with extensive decompression using a surgical microscope. Based on the dissection cadavers and clinical practice, extensive anterior decompression has been designed for mixed cervical spondylosis. It has not been reported that the cervical cord, nerve roots, and vertebral arteries have been decompressed thoroughly at the same time. Fifteen patients with mixed cervical spondylosis were treated with extensive anterior decompression using an operative microscope. The pathologic segments in all patients were identified preoperatively with cervical radiography, myelography, computed tomography, computed tomographic myelography, and magnetic resonance imaging. The Japanese Orthopaedic Association classification was used to assess the follow-up results. The operative results demonstrated the efficacy of the surgical approach. All patients improved neurologically, with the average Japanese Orthopaedic Association score improving from 6.3 points preoperatively to 12.4 points at follow-up examination. The plain radiography, computed tomography, and magnetic resonance imaging follow-up examination showed that the anterior part of the cervical canal and the transversaria or neural foramina were enlarged, and that there was satisfactory bony fusion without signs of nonunion and other complications. Extensive anterior decompression (resection of uncovertebral joints, neural and transverse foraminotomy, subtotal corpectomy, and fusion with strut graft), a new surgical procedure for treating mixed cervical spondylosis, led to excellent follow-up results.