Introduction: Corpectomy and/or discectomy are commonly performed in the treatment of multilevel cervical myelopathy. However, it is unknown whether outcomes are different between corpectomy or multilevel discectomy. We compared 2-level corpectomy against 3-level discectomy by assessing spinal alignment, adjacent level disease, pain, and neurologic function.
Methods: From 2006 to 2011 all patients that underwent cervical 2-level corpectomy or 3-level discectomy were identified. Estimated blood loss and complications were recorded. Outcomes examined included spinal alignment, adjacent segment disease, visual analogue scale (VAS) neck pain, and Nurick scores. Spinal alignment was measure utilizing Cobb’s angle. Adjacent segment disease was defined as any adjacent level disease requiring steroid injections and/or surgery. Fischer exact test and student’s two tailed t-test were used to compare the two groups.
Results: 21 patients underwent corpectomy and 9 patients underwent discectomy. In the corpectomy group, mean age was 56.5 years and 66.6% were male. In the discectomy group mean age was 59.3 years and all patients were male. There were no significant differences in comorbidities, preoperative pain, preoperative Nurick score, and preoperative spinal alignment between the two groups. Corpectomy was associated with significantly higher blood loss (326.2 cc vs. 130.0 cc, p=0.004). Overall complication rate for corpectomy was 9.5%. There were no complications following discectomy (0.0%) (p=0.893). There were no significant differences in follow-up VAS neck pain score (1.2 vs.1.1, p=0.945), Nurick score (1.1 vs. 0.6, p=0.444), correction of spinal alignment (11.1 vs. 8.3, p=0.475), and rate of adjacent level disease (9.5% vs. 0.0%, p=0.338). Mean follow-up 17.7 months and 13.3 months for the corpectomy group and discectomy group, respectively.
Conclusions: These findings suggest 2-level corpectomy and 3-level discectomy offer similar outcomes in regards to spinal alignment, adjacent disease, neck pain, and neurologic function. However, the corpectomy cohort experienced greater blood loss and a slightly higher complication rate.
Patient Care: This research will improve patient care by providing an empiric comparison between reasonable anterior treatment options for multilevel cervical spondylosis with associated myelopathy.
Learning Objectives: By the conclusion of this session, participants should be able to describe the comparison in outcomes, blood loss, and complication rates between patients undergoing 2-level anterior cervical corpectomy vs. 3 level anterior cervical discectomy and fusion.