Lateral position posterior surgery followed by supine position anterior surgery in a single stage (LP-A) for the treatment of cervical spinal cord anterior severe dynamic compression in short-term

To evaluate the effectiveness and safety of the lateral position posterior surgery ahead of the anterior surgery (LP-A) in a single stage for releasing the cervical spinal cord from short-term severe anterior compression. The severe stenosis with dynamic compression defined as Vaccaro`s system degree 3 or 4 with neurological symptoms aggravation when flexion or extension of the cervical spine. Retrospectively analyzed 64 short-level degenerative cervical myelopathy (DCM) patients from severe compression who underwent posterior cervical decompression in the lateral position ahead of supine anterior decompression and fusion at a single stage. Sixty-four patients with DCM from severe compression were enrolled. The mean operation time was 183.06 ± 32.42 min. The postoperative mJOA scores of the patients increased from 7.61 ± 0.94 to 14.03 ± 0.78. The expansion degree of the cervical spinal cross-sectional area and drift-back distance rose from 62.05 ± 14.05 to 164.05 ± 37.62mm2 and from 5.08 ± 1.22 to 12.70 ± 1.26, respectively. The Neck Disability Index was 31.81 ± 3.17 before the operation, 20.14 ± 2.22, 17.69 ± 1.56, 15.64 ± 1.51, and 13.70 ± 1.50 at 1, 3, 6, and 12 months after the operation, respectively. The visual analogue scale (VAS) score of the cervical was 5.64 ± 1.01 before the operation, 2.41 ± 0.64, 2.08 ± 0.48, 1.45 ± 0.50, and 1.06 ± 0.47 at 1, 3, 6, and 12 months after the operation, respectively. The sagittal vertical axis (cSVA) and the Cobb angle were significantly changed after surgery. Posterior cervical decompression in the lateral position ahead of anterior decompression and fusion in a single stage is an effective and safe surgical procedure for the treatment of severe short-term cervical cord anterior compression.