Volume 83, Issue 9 (December 2025)
Tehran Univ Med J. 2025, 83(9): 666-674 |
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Nabiuni M, Tavakoli Pirzaman A, Haditabar H, Haghshenas Dehkordi S, Pahlevaninezhad L, Hadian H. Investigating the prevalence of complications of corpectomy and discectomy surgical methods in the treatment of cervical spondylosis. Tehran Univ Med J. 2025; 83 (9) :666-674
URL: http://tumj.tums.ac.ir/article-1-13863-en.html
URL: http://tumj.tums.ac.ir/article-1-13863-en.html
Mohsen Nabiuni1, Ali Tavakoli Pirzaman1, Hossein Haditabar1, Solmaz Haghshenas Dehkordi1, Leila Pahlevaninezhad1, Hania Hadian2
1- Department of Neurosurgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Biology, Naghshejahan Higher Education Institute, Isfahan, Iran.
2- Department of Biology, Naghshejahan Higher Education Institute, Isfahan, Iran.
Abstract: (131 Views)
Background: Cervical spondylotic myelopathy (CSM) is the most common cause of non-traumatic spinal cord dysfunction in adults. Surgical intervention plays a key role in preventing disease progression and improving functional outcomes in patients with moderate to severe or progressive symptoms. Anterior approaches, including Anterior Cervical Discectomy and Fusion (ACDF) and Anterior Cervical Corpectomy and Fusion (ACCF), are among the most commonly used surgical techniques; however, determining the optimal method remains debatable. This study aimed to determine the prevalence of intraoperative complications and clinical outcomes of discectomy and corpectomy in the treatment of patients with CSM.
Methods: In this retrospective cross-sectional study, the records of patients with CSM who underwent anterior cervical surgery at Tehran Rasoul Akram Hospital between April 2018 to March 2022 were reviewed. Patients with a history of previous cervical spine surgery, non-degenerative causes of myelopathy, or insufficient follow-up were excluded. Collected data included demographic, intraoperative variables, neurological complications, clinical outcomes, and radiological findings.
Results: A total of 86 patients were included in the study, of whom 95.3% underwent ACDF and 4.7% underwent ACCF. The age and gender distribution showed no significant difference between the groups. Intraoperative neuromonitoring was used in most patients. The bone fusion rate was high in both groups, and no cases of dural tear or vascular injury were observed. Clinical symptom improvement was reported in the majority of patients in the discectomy group. In contrast, corpectomy was associated with longer operative time and greater blood loss. The occurrence of complications such as dysphagia, dyspnea, and recurrent laryngeal nerve involvement was generally transient and showed no significant correlation with the surgical level or patient demographics.
Conclusion: The findings of this study indicate that both ACDF and ACCF are safe and effective in the treatment of cervical spondylotic myelopathy. However, due to reduced operative time, less bleeding, and a higher rate of symptom improvement, discectomy may be considered the preferred treatment option in selected patients. Prospective studies with larger sample sizes and cost-effectiveness analyses are recommended to determine the optimal treatment strategy.
Methods: In this retrospective cross-sectional study, the records of patients with CSM who underwent anterior cervical surgery at Tehran Rasoul Akram Hospital between April 2018 to March 2022 were reviewed. Patients with a history of previous cervical spine surgery, non-degenerative causes of myelopathy, or insufficient follow-up were excluded. Collected data included demographic, intraoperative variables, neurological complications, clinical outcomes, and radiological findings.
Results: A total of 86 patients were included in the study, of whom 95.3% underwent ACDF and 4.7% underwent ACCF. The age and gender distribution showed no significant difference between the groups. Intraoperative neuromonitoring was used in most patients. The bone fusion rate was high in both groups, and no cases of dural tear or vascular injury were observed. Clinical symptom improvement was reported in the majority of patients in the discectomy group. In contrast, corpectomy was associated with longer operative time and greater blood loss. The occurrence of complications such as dysphagia, dyspnea, and recurrent laryngeal nerve involvement was generally transient and showed no significant correlation with the surgical level or patient demographics.
Conclusion: The findings of this study indicate that both ACDF and ACCF are safe and effective in the treatment of cervical spondylotic myelopathy. However, due to reduced operative time, less bleeding, and a higher rate of symptom improvement, discectomy may be considered the preferred treatment option in selected patients. Prospective studies with larger sample sizes and cost-effectiveness analyses are recommended to determine the optimal treatment strategy.
Keywords: anterior cervical surgery, cervical spondylotic myelopathy, corpectomy, discectomy, spinal fusion, surgical complications.
Type of Study: Original Article |
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