Anterior Controllable Antedisplacement and Fusion (ACAF) Technique for the Treatment of Multilevel Cervical Spondylotic Myelopathy With Spinal Stenosis (MCSMSS)

Study Design: Retrospective study. Objective: To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), compared with hybrid decompression fixation (HDF). Summary of Background Data: A retrospective analysis of 94 cases with MCSMSS was carried out. Fifty-four patients were treated with ACAF, whereas 40 patients were treated with HDF. Methods: The operation time, intraoperative blood loss, postoperative complications, Japanese Orthopedic Association score, Neck Disability Index score, parameters at axial computed tomography, cervical curvature and the Kang grade were compared between 2 groups. Results: The patients were followed up for 12–17 (15.6±1.6) months. Compared with HDF, ACAF group achieved better decompression according to computed tomography measurement and Kang grade ( P <0.05), and recovered to a greater cervical Cobb angle ( P <0.05). However, Japanese Orthopedic Association score and Neck Disability Index showed no significant difference 1 year after surgery ( P >0.05). In addition, ACAF presented longer operation time ( P <0.05) and similar intraoperative blood loss ( P >0.05), compared with HDF. In terms of complications, ACAF produced less incidences of cerebrospinal fluid leakage, implant complication, epidural hematoma, and C5 palsy compared with HDF. Conclusions: ACAF is an effective method for the treatment of MCSMSS. In comparison to HDF, ACAF has the advantages of more sufficient decompression, more satisfactory cervical curvature, and lower incidence rates of complications.