Anterior cervical decompression and spine fusion for spondylotic myelopathy
Benefits of anterior decompression and spine fusion surgery
In the past, cervical laminectomy [4] (removing the posterior aspects of the spinal canal) to decompress (relieve pressure on) the spinal cord had been the
procedure of choice to treat spondylotic myelopathy resulting from cervical arthritis.
However, the majority of the abnormal anatomy producing spinal cord compression is located anteriorly to (in front of) the spinal cord itself. This is only indirectly addressed by a posterior cervical laminectomy. In fact, chronic spinal instability exacerbating the disease process may be caused by cervical laminectomy. In addition, a thick fibrous scar forms at the operative site in the postoperative period, at times replacing the bony compression and reproducing the original symptoms after an extended postoperative period.
For these reasons, many surgeons prefer either anterior decompression of the spinal cord and nerve roots, or an adaptation of laminectomy known as laminoplasty, depending on the patient's anatomy. Anterior cervical decompressions have two significant benefits:
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Direct removal of the anterior source of spinal cord compression.
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Stabilization of the spine by way of a fusion, eliminating motion and the development of further degenerative changes at the operated levels.