Neurological and Biomechanical Evaluation of 72 Patients with Degenerative Cervical Spondylotic Myelopathy at 3, 6, and 12 Months Following Anterior Cervical Corpectomy and Fusion

对 72 例退行性颈椎病患者行前路颈椎椎体切除融合术后 3、6 和 12 个月进行神经学和生物力学评估

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Abstract

BACKGROUND Degenerative cervical spondylotic myelopathy (CSM) is an age-related degenerative condition of the vertebral bodies, discs, and ligaments that can cause pressure on the spinal cord and nerves. Anterior cervical corpectomy and fusion is a widely used surgical approach for treating CSM, aiming to decompress the spinal cord, restore vertebral alignment, and improve fusion rates, thus providing relief to affected patients. This study was a neurological and biomechanical evaluation of 72 patients with degenerative CSM at 3, 6, and 12 months following anterior cervical corpectomy and fusion. MATERIAL AND METHODS This retrospective study included 72 patients with a diagnosis of CSM based on modified Japanese Orthopaedic Association (mJOA) scores (10-14) and magnetic resonance imaging evidence of spinal cord compression. Neurological function and cervical biomechanics were evaluated preoperatively and at 3, 6, and 12 months postoperatively. Assessments included mJOA scores, 3-dimensional cervical range of motion (measured by Coda motion system), cervical sagittal alignment (Cobb angle, sagittal vertical axis, T1 slant angle), and neck disability index. RESULTS Postoperative assessments showed significant improvements in neurological function (mJOA scores increased by 45% at 12 months, P<0.05) and cervical range of motion (mean improvement 22% at 12 months, P<0.05). Neck disability index significantly decreased (from 44.43 to 30.17, P<0.05). Postoperative imaging confirmed positive changes in cervical sagittal alignment. CONCLUSIONS Anterior cervical corpectomy and fusion significantly improves cervical biomechanics and neurological function in patients with CSM, contributing to better clinical outcomes. Further long-term studies are needed for durability and adjacent segment degeneration.

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