Comparative Study between Anterior Cervical Discectomy and Fusion with Posterior Laminectomy and Lateral Mass Fixation in Management of Subaxial Cervical Cord Myelopathy

The most frequent reason for spinal cord dysfunction is cervical spondylotic myelopathy. To compare anterior cervical discectomy and fusion with posterior laminectomy and lateral mass fixation for managing subaxial multiple-level cervical cord myelopathy, reporting clinical, imaging, and surgical outcomes for at least one and a half years, The present research has been performed prospectively on thirty cases with multiple-level cervical canal stenosis not responding to conservative medical treatment operated in the Neurosurgery department in Al-Zahraa University Hospital started from 2021 to 2023. Clinical examination showed motor deficits in the upper limbs in 93.3% of patients, with 63.3% involving both limbs, spasticity in 60%, hyperreflexia in 66.7%, positive Babinski in 70%, Hoffman in 60%, and ankle clonus in 46.7%. Blood loss averaged 252.3±80.8 mL (Group A) and 550.15±35.4 mL (Group B). Preoperative mJOA scores were 13.03±2.92 (Group A) and 11.8±2.91 (Group B), improving to 15.4±2.63 and 14.33±2.92 postoperatively, with changes of 1.60±1.99 and 2.53±1.6. Complications included dural tears, dysphagia, hoarseness, and weakness in 3.3% each in Group A, while Group B had one C5 palsy (3.3%), two wound infections (13%), and two system failures (13%). Both anterior and posterior approaches effectively manage cervical spondylotic myelopathy, with the anterior approach offering shorter operative times and less blood loss, while the posterior approach is suitable for multilevel disease, improving clinical outcomes and quality of life.