• Hongjie Zhang, Shenglin Wang, Zhechen Li, Rongkai Shen, Renqin Lin, Wence Wu, and Jianhua Lin.
• Department of Spinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
• World Neurosurg. 2019 Jul 1; 127: e910-e918.

ObjectiveTo provide a quantitative assessment of clinical outcomes of anterior cervical surgery for patients with Hirayama disease.MethodsNineteen patients undergoing anterior cervical surgery were retrospectively collected, and preoperative and postoperative clinical and radiographic data were compared.ResultsAll patients had a mean follow-up time of 72.5 ± 30.6 months. Tremor in 6 of 14 patients and cold paralysis in 8 patients were resolved after operation. Grip strength of upper extremities was significantly improved (preoperative 15.67 ± 2.74 kg vs. postoperative 19.82 ± 2.89 kg, P < 0.001). Postoperative cervical lordosis was significantly increased to 6.41 ± 4.39 mm from 2.70 ± 4.61 mm (P < 0.001). The overall range of cervical flexed motion was significantly decreased (preoperative 33.10° ± 10.60° vs. postoperative 13.55° ± 6.69°, P < 0.001), with segmental range of C5-6 (preoperative 12.52° ± 7.13° vs. postoperative 7.04° ± 3.75°, P = 0.002) and C6-7 (preoperative 9.01° ± 5.01° vs. postoperative 5.73° ± 2.74°, P = 0.014) contributing significantly to the improvement. Postoperative angle mobility of C3-4 to C6-7 was significantly decreased (P < 0.001). Postoperative neutral magnetic resonance imaging showed the transverse area of spinal cord of C6 (P = 0.016) and C7 (P = 0.021) was significantly increased.ConclusionsAnterior cervical surgery can provide clinical efficacy and imaging improvement, including reduced range of cervical flexed motion and angle mobility of lower cervical spine and increased cervical lordosis and spinal cord area.Copyright © 2019 Elsevier Inc. All rights reserved.

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