• Mary R A Cunningham, Stuart Hershman, and John Bendo.
• Orthopedics International, Seattle, WA, USA. cunninghamspine@yahoo.com
• Spine. 2010 Mar 1; 35 (5): 537-43.

Study DesignSystematic review of cohort studies comparing surgical treatment options for cervical spondylotic myelopathy.ObjectiveCompare results of major surgical treatments.Summary Of Background DataControversy exists between various surgical options for the treatment of multilevel cervical spondylotic myelopathy, including multilevel corpectomy (CORP) and fusion, anterior cervical discectomy and fusion, laminoplasty (LAMP), and laminectomy and fusion (LAMI). A systematic review was done in order to compare results and complications among these procedures.MethodsSystematic review of retrospective cohort studies comparing anterior cervical discectomy and fusion (ACDF), CORP, LAMP, and LAMI from 1980 to January 2008. Separately, a review was performed of case series with greater than 10-year follow-up.ResultsAbout 1735 articles found initially, 591 abstracts screened, 36 articles retrieved in full, 11 studies included in review. All comparison studies are retrospective cohort studies. Four studies compared multilevel CORP versus LAMP, 1 study compared LAMI with LAMP, and 2 studies compared ACDF with LAMP. There were 3 case studies with greater than 10-year follow-up.ConclusionAll approaches yield similar neuro recovery rates. Laminoplasty has a significant incidence of neck pain compared with multilevel CORP. ACDFs increase the rate of adjacent secondary spondylosis compared with LAMP. Multilevel CORP and laminectomy with fusion have a significantly higher rate of graft, instrumentation, and approach related complications. Multilevel CORP and laminectomy with fusion have a significant decrease in range of motion of neck compared with LAMP.

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