Evaluation of Anterior Decompression Surgical Outcomes of Proximal-type Cervical Spondylotic Amyotrophy, a Retrospective Study

Abstract Background To investigate the effect of anterior decompression on cervical spondylotic amyotrophy patients with cervical radiculopathy. Methods From January 2012 to December 2016, 21 patients with proximal-type cervical spondylotic amyotrophy(CSA) underwent anterior decompression were included. There were 15 males and 6 females, aged 35-73 years with an average of 51.62 years. All underwent surgery of anterior decompression (ACDF or ACCF). Among them, 12 patients underwent C4/5 single level ACDF, 8 patients underwent C4/5 and C5/6 double level ACDF, and one patient underwent C5 anterior cervical corpectomy decompression and fusion surgery. Preoperative and postoperative clinical and radiologic results were assessed. The evaluation items include muscle strength, visual analog scale (VAS) score, neck disability index (NDI) score, Japanese Orthopedic Association (JOA) score, and improvement rate at the last follow-up. Neurological and radiological follow-up averaged 13.2 months. Results Severe preoperative muscle atrophy was observed in the deltoid or biceps muscles of 21 patients before surgeries. At the final follow-up, all patients showed statistically improvements in muscle strength, VAS scores, and NDI scores (P<0.05, P<0.05, P<0.05), especially for the deltoid muscles force and JOA scores (P<0.01, P<0.01), of which the average improvement rates were 66.49±10.04% and 62.23±9.23%, respectively. Conclusions For CSA patients, especially resulted from cervical radiculopathy, anterior decompression surgery can improve patient's muscle strength and nerve root compression symptoms and generally achieve satisfactory curative effects