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Choice of Surgical Treatment for Multisegmental Cervical Spondylotic Myelopathy

YONENOBU, KAZUO, MD*; FUJI, TAKESHI, MD*; ONO, KEIRO, MD*; OKADA, KOZO, MD*; YAMAMOTO, TOMIO, MD; HARADA, NORIMASA, MD

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Three surgical procedures for multisegmental cervical spondylotic myelopathy were evaluated on the basis of a follow-up study (12-157 months) of 95 patients. Twenty-four patients were treated by extensive laminectomy, 50 by anterior interbody fusion by the Cloward and/ or Smith-Robinson techniques, and 21 by subtotal spondylectomy and fusion. Results of subtotal spondylectomy were significantly (P < 0.01) better when compared with those of the other two procedures. It was concluded that spondylosis up to three disc levels should be treated by subtotal spondylectomy and fusion regardless of the canal diameter. When involvement extended four or more levels, extensive laminectomy was recommended.

*From the Department of Orthopaedic Surgery, Osaka University Medical School, Hukushima-ku Osaka 553 Japan

†From the Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, Hukushima-ku Osaka 553 Japan

© Lippincott-Raven Publishers.