Treatment of spondylotic cervical myelopathy: Anterior cervical discectomy and fusion with a modular plate-cage system (PCB) in the singlelevel and multilevel cervical myelopathy

Study Design: A retrospective, clinical, and radiographic study. Objective: To evaluate the clinical and radiologic outcome of patients treated for cervical spondylosis by anterior cervical discectomy and fusion with the plate-cage system (PCB). Summary of Background Data: Cervical spondylosis and its clinical manifestations are common pathologic entities. The goal of surgical treatment is to decompress the cervical spinal canal and achieve an arthrodesis of the treated levels. Several factors must be considered in choosing the best approach, and to date, there has not been any universal consensus. Methods: A total of 152 consecutive patients with cervical spondylotic myelopathy underwent anterior cervical discectomy and fusion surgery with the PCB, between 2000 and 2007, with a minimum follow-up of 12 months (range, 12 to 70 mo; mean: 47.4). All patients were evaluated preoperatively and postoperatively using magnetic resonance imaging, dynamic x-ray, Nurick, and the modified Japanese Orthopedic Association score. Results: Out of the entire group of patients, 112 cases presented with a single-level compression whereas 40 patients were affected by multilevel (2 or 3 levels) cervical stenosis. The postoperative clinical follow-up showed an improvement in 126 cases (82.9%), with no changes in 16 (10.5%) but a worsening in 10 (6.6%). Conclusions: Anterior decompression and PCB plate-cage fixation for singlelevel or multilevel cervical stenosis represent a safe, simple, fast, and less invasive technique with excellent neuroradiological and clinical postoperative results. Moreover, this particular anterior technique reduced the mean hospital stay and the rate of intraoperative and postoperative complications.