• Qunxiang Chen, Mingyue Qin, Fei Chen, Bin Ni, Qunfeng Guo, and Zhao Han.
• Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
• World Neurosurg. 2019 May 1; 125: e341-e347.

ObjectiveTo compare the outcome of anterior cervical decompression and fusion (ACDF) and posterior laminoplasty (LAMP) for treating 4-level cervical spondylotic myelopathy (CSM).MethodsData of 80 patients with 4-level CSM treated using ACDF and another 56 cases treated using LAMP were retrospectively analyzed. Radiologic outcomes evaluated by C2-7 Cobb angle and cervical range of motion (ROM) and functional outcomes evaluated by Japanese Orthopaedic Association (JOA) scale score and visual analog scale score for axial pain were compared between the 2 groups.ResultsJOA scale score in both groups improved significantly after operation (P < 0.05). There was no significant difference in the JOA scale score improvement rate between the 2 groups (P > 0.05). The C2-7 Cobb angle increased significantly in the ACDF group (P < 0.05) and decreased in the LAMP group (P > 0.05). There was a significant difference in C2-7 Cobb angle improvement between the 2 groups (P < 0.05). Cervical ROM decreased in both groups after operation (P < 0.05), but there was no significant difference in ROM loss ratio between the 2 groups (P > 0.05). Blood loss in the LAMP group was significantly more than in the ACDF group (P < 0.05); however, there was no significant difference in operation time between the 2 groups (P > 0.05). There was no significant difference in the complication rate between the 2 groups (P > 0.05).ConclusionsBoth ACDF and LAMP were effective in the treatment of multilevel CSM. Compared with LAMP, ACDF is less invasive and may be more suitable for elderly patients with poor tolerance of surgery.Copyright © 2019 Elsevier Inc. All rights reserved.

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