Comparative Analysis of Anterior Corpectomy versus Laminoplasty Efficacy in Radiological Outcomes for Cervical Spondylotic Myelopathy Treatment

Comparative Analysis of Anterior Corpectomy versus Laminoplasty Efficacy in Radiological Outcomes for Cervical Spondylotic Myelopathy Treatment | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparative Analysis of Anterior Corpectomy versus Laminoplasty Efficacy in Radiological Outcomes for Cervical Spondylotic Myelopathy Treatment Mehmet Besir SURME, Bekir AKGÜN, Efecan CEKIC, Mehmet ISCI, Hanefi YILDIRIM This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5380744/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective This study aims to assess the radiological outcomes of anterior corpectomy compared to laminoplasty in treating Cervical Spondylotic Myelopathy (CSM), focusing on postoperative improvements in key imaging metrics. Materials and Methods A retrospective cohort analysis evaluated 45 patients diagnosed with CSM who underwent anterior corpectomy (21 patients) or laminoplasty (24 patients). Radiological outcomes were measured by comparing preoperative and 6-month postoperative CT and MRI scans, focusing on the Harrison posterior tangent curve, sagittal vertical axis (SVA), cranial tilt, cervical tilt, Jackson stress curve and cobb angle. Results The study found statistically significant improvements in Harrison posterior tangent curve, SVA and cranial tilt measurements for both surgical methods. No significant differences were observed between the two surgical techniques when comparing the ratio of post-operative to pre-operative values. Conclusion Both anterior corpectomy and laminoplasty were effective in altering radiological parameters in the treatment of CSM, with no significant difference in efficacy between the two techniques. These findings underscore the importance of a tailored approach to surgical intervention in CSM, with decisions based on individual patient anatomy and clinical presentation. Further studies with larger patient populations are needed to confirm these results and establish standardized radiological benchmarks for surgical outcomes in CSM treatment. Cervical Spondylotic Myelopathy Cervical Radiological Measurements Corpektomy Laminoplasty Figures Figure 1 Figure 2 Figure 3 INTRODUCTION Cervical Spondylotic Myelopathy (CSM) stems from chronic cervical spinal cord compression due to degenerative changes, leading to functional deterioration and diminished quality of life(Kalsi-Ryan et al., 2013 ). It represents a significant clinical entity characterized by a constellation of symptoms, including neck pain, spasticity, weakness, and sensorimotor deficits, attributable to the compression of the cervical spinal cord(Iyer et al., 2016 ). Adult spinal cord impairment frequently necessitates surgery to arrest neurological deterioration and possibly ameliorate myelopathy(Williams et al., 2022 ). The advent of surgical treatments for CSM has traditionally revolved around two mainstays: anterior corpectomy and laminoplasty(Edwards et al., 2002 ; Seng et al., 2013 ). Anterior corpectomy aims at decompression by directly removing the compressive pathology and stabilizing the segment through spinal fusion(Pescatori et al., 2020 ). In contrast, laminoplasty seeks to expand the spinal canal indirectly by remodeling the laminae, thus preserving motion and obviating the need for fusion(Paracino et al., 2021 ). Each approach, anterior and posterior, brings unique benefits and challenges, and the decision-making process in selecting an appropriate surgical technique is often influenced by many factors, including the severity of compression, the number of levels involved, and the alignment of the cervical spine(Montano et al., 2019 ). Modern medical advancements necessitate a rigorous reevaluation of surgical methods, mainly focusing on radiological assessments to gauge the efficacy of interventions such as anterior corpectomy and laminoplasty. Our study, distinct from other clinical evaluations, emphasizes radiological outcomes by employing comprehensive statistical analyses to ensure precise interpretation of postoperative improvements, thereby reinforcing the significance of imaging in assessing these surgical techniques. This research is particularly critical given the context of an aging population and the resulting increase in degenerative spinal conditions. By evaluating the postoperative improvements across various radiological parameters, including the Harrison posterior tangent curve (Harrison Post), sagittal vertical axis (SVA), and cranial tilt, we endeavored to elucidate the comparative effectiveness of the anterior corpectomy and laminoplasty to inform clinical decisions and optimize patient outcomes in the treatment of CSM. MATERIALS AND METHODS This study evaluated the radiological improvements in patients undergoing anterior corpectomy and laminoplasty to treat CSM. A retrospective analysis of the clinical data was conducted on a cohort of patients who underwent either surgical approach. Informed consent was obtained from all patients in the study, and patient anonymity was preserved throughout the analysis. Our study received ethical approval on 27/02/2023 with decision Number is 9. Patient Selection and Data Collection The study retrospectively analyzed 45 patients, consisting of 33 men and 12 women, who underwent surgical treatment for CSM between 2016 and 2022. These patients were treated with either anterior corpectomy (21 patients) or laminoplasty (24 patients). Radiological Assessment Preoperative and 6-month postoperative CT scans and/or MR images were analyzed. Preoperative and postoperative sixth-month radiological data were collected from medical records, including parameters such as Harrison posterior tangent curve (Harrison Post), Sagittal Vertical Axis (SVA), Cranial Tilt, Cobb Angle, Jackson Stress curve, and cervical tilt, which is depicted in Fig. 1 . Measurements were standardized according to established protocols to ensure consistency across the evaluations. The radiological assessment was measured using criteria the Cervical Spine Research Society set. Statistical Analysis The statistical analyses were presented as mean ± standard error of the mean (SEM). An unpaired t-test (one-sided p-value) was used to compare parameters between the preoperative and postoperative groups. The effectiveness of corpectomy and laminoplasty approaches was evaluated using the PostOp./PreOp—the ratio from different parameters. The comparison was performed using GraphPad Prism 8.01 (GraphPad Software, USA) software. The degree of significance was denoted as * p < 0.05 and ** p < 0.01. RESULTS Our statistical analysis compared the radiological improvements in CSM patients who underwent either anterior corpectomy or laminoplasty. The data was subdivided into two groups based on the surgical approach they received. We evaluated multiple parameters, including the Harrison posterior tangent curve (Harrison Post), Sagittal Vertical Axis (SVA), Cranial Tilt, Cobb Angle, and Jackson Stress test. These were measured preoperatively and six months post-operation. The corpectomy group significantly reduced the Harrison Post measurement from preoperative 24.32 ± 2.47 to postoperative 17.42 ± 2.52 (*p* = 0.0295). Similarly, the laminoplasty group reduced from 28.42 ± 2.28 to 21.58 ± 2.45 (*p* = 0.0242). There was a statistically significant increase in both groups postoperatively for the Sagittal Vertical Axis. The corpectomy group changed from 19.90 ± 2.14 to 28.10 ± 2.66 (*p* = 0.0107), and the laminoplasty group from 18.21 ± 2.43 to 25.42 ± 2.62 (*p* = 0.0250). Cranial Tilt also increased significantly after surgery in both groups, with the corpectomy group changing from 6.61 ± 1.18 to 12.24 ± 1.62 (**p** < 0.01) and the laminoplasty group from 6.83 ± 1.39 to 12.13 ± 1.37 (**p** < 0.01). However, Cobb Angle, Jackson Stress, and cervical tilt changes did not show statistical significance in either group, as presented in Table 1 and Figure 2 . When comparing the effectiveness of the two approaches by evaluating the ratio of post-operative to pre-operative values, no statistically significant differences were found between the two surgical techniques. Harrison Post ratio was 0.91 ± 0.14 for corpectomy and 0.94 ± 0.10 for laminoplasty (p = 0.4220). The Sagittal Vertical Axis ratio was 1.58 ± 0.14 for corpectomy and 1.64 ± 0.22 for laminoplasty (p = 0.4216). The cranial Tilt ratio was 3.01 ± 0.56 for corpectomy and 3.22 ± 0.82 for laminoplasty (p = 0.4172), demonstrated in Table 2 and Figure 3 . These results suggest that while both surgical techniques effectively alter the radiological parameters in the treatment of CSM, there is no clear superiority of one method over the other regarding the radiological outcomes measured. DISCUSSION The management of cervical spondylotic myelopathy (CSM) has evolved to include a spectrum of surgical interventions tailored to the complexity of spinal pathology and patient-specific anatomical considerations. Anterior corpectomy has been validated for significant neurological recovery, particularly in cases involving fewer segments and multilevel ossification of the posterior longitudinal ligament(Fessler et al., 1998 ; Lee et al., 2008 ). Despite these advantages, anterior corpectomy is associated with higher reoperation rates, longer operation times, and increased blood loss, suggesting a careful patient selection process(Huang et al., 2016 ; X. Liu et al., 2014 ). On the other end of the spectrum, posterior laminoplasty remains the cornerstone for multilevel cervical myelopathy, particularly when the number of segments involved precludes an anterior approach(J. Liu et al., 2023 ; TÜRKOĞLU et al., 2021 ; Ud Din Hoti et al., 2018 ). However, when local kyphotic deformity, OPLL, or segmental instability complicates the clinical picture, standalone laminoplasty may not suffice(Badhiwala et al., 2020 ). Zhong et al. ( 2023 ) suggested that open-door laminoplasty (LAMP) may be advantageous for preserving cervical mobility and minimizing postoperative complications in treating four-level cervical spondylotic myelopathy. While all three procedures demonstrated improvements in the JOA, NDI, and VAS scores, LAMP showed a slight reduction in range of motion, a critical factor for postoperative quality of life. Given these outcomes, LAMP could be considered the preferred option when surgical goals prioritize mobility preservation and lower complication rates(Zhong et al., 2023 ). The literature review by K. Bridges et al. ( 2018 ) introduces a compelling case for the amalgamation of laminoplasty with posterior fusion in such intricate cases. This combined approach addresses the dual objectives of decompression and stabilization, which are paramount in scenarios in which traditional laminoplasty may fall short. Specifically, in the presence of local kyphotic deformity or segmental instability, the additional fusion can mitigate the risk of postoperative deformity progression and ensure spinal cord decompression(Bridges et al., 2018 ). Our study complements the findings of Li et al., in which clinical characteristics and MRI indicators were correlated with surgical results(Li et al., 2018 ). While Li et al. identified factors such as the duration of symptoms and specific MRI signal changes as predictive of outcomes, our research adds a quantitative dimension to the assessment process. Our investigation into the predictive radiological parameters for CSM surgery outcomes aligns with the work of Khan et al., who elucidated the role of MRI in assessing tissue injury within the cervical spinal cord(Khan et al., 2023 ). The concurrence between our studies lies in recognizing MRI's diagnostic power, with our research providing actionable insights through measurable spinal changes pre-and post-surgery. This combined approach enriches the understanding of CSM pathology and fosters a more informed surgical decision-making process that can significantly improve patient management and recovery. Together, these studies suggest a multifaceted predictive model that combines clinical presentations with a robust radiological assessment to enhance the prognostic accuracy of CSM surgery. Our study is a pivotal reference for surgical decision-making and patient follow-up in the intricate landscape of CSM treatment. By underpinning the prognostic value of radiological assessments, we provide a clear rationale for incorporating specific radiological parameters into the standard preoperative and postoperative evaluation framework. These parameters are critical indicators correlating with patient recovery and quality of life. Their integration into clinical practice allows for a nuanced approach beyond subjective assessment, offering a data-driven strategy that refines the choice of surgical technique and the anticipated outcomes. Our findings mainly highlight the importance of personalized care in CSM management. Despite its potential for significant neurological improvement, anterior corpectomy must be judiciously considered against its higher associated risks, as our research indicates. Alternatively, posterior approaches, especially those combined with fusion, have emerged as a compelling option for more complex cases in which structural stability and alignment are paramount. This evidence-based approach ensures that surgical plans are not static but evolve in response to patient-specific needs and the dynamic nature of spinal pathologies. The retrospective design and modest cohort size of our study limit its scope, potentially introducing selection bias and constraining the statistical robustness of the findings. Future research should address these limitations by employing a prospective, multicenter approach with a larger patient population, extending the investigation to encompass long-term clinical outcomes, patient quality of life, and the utility of advanced imaging modalities to deepen the understanding of cervical spondylotic myelopathy treatment efficacy. The ultimate goal of our study was to enhance the surgical treatment framework for CSM by advocating a patient-centered bespoke plan. This plan, informed by our validated radiological parameters, aimed to maximize neurological recovery while minimizing complications. This underscores the need for a multidisciplinary team to manage CSM, a condition that demands as much precision in its surgical intervention as it does compassion in its aftercare. Our research lays the groundwork for such an approach, guiding the surgical community toward more informed and effective treatment paradigms. CONCLUSION Our comprehensive radiological assessment provides a valuable perspective on the efficacy of anterior corpectomy and laminoplasty in managing cervical spondylotic myelopathy (CSM). While both surgical techniques demonstrated significant improvements in parameters such as the Harrison posterior tangent curve, Sagittal Vertical Axis, and Cranial Tilt, our findings suggest no distinct superiority of one procedure. This complements the work of Li et al., which correlates clinical characteristics with MRI predictors for surgical outcomes, and the research by Khan et al., which highlighted MRI's utility of MRI in quantifying spinal tissue injury. These studies underscore the need to integrate clinical insights with advanced imaging analytics to inform surgical strategies and patient-specific care. Surgical decision-making and prognostic follow-up processes must be guided by balanced consideration of radiological data and clinical presentation to provide patients with the most favorable prognostic outcomes and quality of life post-surgery. Declarations Ethical Approval : Our study received ethical approval on 27/02/2023 with decision Number is 9. Competing interests: There are no any competing interests between the authors. Authors' contributions: Mehmet Besir SURME and Mehmet ISCI wrote the main manuscript text and Efecan CEKIC , Bekir AKGUN and Hanefi YILDIRIM prepared figures 1-3 and tables All authors reviewed the manuscript. Funding: There is no funding Availability of data and materials: There is no materials References Badhiwala, J. H., Ellenbogen, Y., Khan, O., Nouri, A., Jiang, F., Wilson, J. R. F., Jaja, B., Witiw, C. D., Nassiri, F., Fehlings, M. G., & Wilson, J. R. (2020). Comparison of the Inpatient Complications and Health Care Costs of Anterior versus Posterior Cervical Decompression and Fusion in Patients with Multilevel Degenerative Cervical Myelopathy: A Retrospective Propensity Score–Matched Analysis. World Neurosurgery , 134 , e112–e119. https://doi.org/10.1016/j.wneu.2019.09.132 Bridges, K. J., Simpson, L. N., Bullis, C. L., Rekito, A., Sayama, C. M., & Than, K. D. (2018). Combined Laminoplasty and Posterior Fusion for Cervical Spondylotic Myelopathy Treatment: A Literature Review. Asian Spine Journal , 12 (3), 446–458. https://doi.org/10.4184/asj.2018.12.3.446 Edwards, C. C., Heller, J. G., & Murakami, H. (2002). Corpectomy Versus Laminoplasty for Multilevel Cervical Myelopathy. Spine , 27 (11), 1168–1175. https://doi.org/10.1097/00007632-200206010-00007 Fessler, R. G., Steck, J. C., & Giovanini, M. A. (1998). Anterior Cervical Corpectomy for Cervical Spondylotic Myelopathy. Neurosurgery , 43 (2), 257–265. https://doi.org/10.1097/00006123-199808000-00044 Huang, D., Du, X., Liang, H., Hu, W., Hu, H., & Cheng, X. (2016). Anterior corpectomy versus posterior laminoplasty for the treatment of multilevel cervical myelopathy: A meta-analysis. International Journal of Surgery , 35 , 21–27. https://doi.org/10.1016/j.ijsu.2016.09.008 Iyer, A., Azad, T. D., & Tharin, S. (2016). Cervical Spondylotic Myelopathy. Clinical Spine Surgery: A Spine Publication , 29 (10), 408–414. https://doi.org/10.1097/BSD.0000000000000397 Kalsi-Ryan, S., Karadimas, S. K., & Fehlings, M. G. (2013). Cervical Spondylotic Myelopathy. The Neuroscientist , 19 (4), 409–421. https://doi.org/10.1177/1073858412467377 Khan, A. F., Haynes, G., Mohammadi, E., Muhammad, F., Hameed, S., & Smith, Z. A. (2023). Utility of MRI in Quantifying Tissue Injury in Cervical Spondylotic Myelopathy. Journal of Clinical Medicine , 12 (9), 3337. https://doi.org/10.3390/jcm12093337 Lee, S.-H., Ahn, Y., & Lee, J. H. (2008). Laser-Assisted Anterior Cervical Corpectomy versus Posterior Laminoplasty for Cervical Myelopathic Patients with Multilevel Ossification of the Posterior Longitudinal Ligament. Photomedicine and Laser Surgery , 26 (2), 119–127. https://doi.org/10.1089/pho.2007.2110 Li, X.-Y., Lu, S.-B., Sun, X.-Y., Kong, C., Guo, M.-C., Sun, S.-Y., Ding, J.-Z., & Yang, Y.-M. (2018). Clinical and magnetic resonance imaging predictors of the surgical outcomes of patients with cervical spondylotic myelopathy. Clinical Neurology and Neurosurgery , 174 , 137–143. https://doi.org/10.1016/j.clineuro.2018.09.003 Liu, J., Wang, J., Ding, Z., Hai, Y., Zhang, Y., Kang, N., & Wang, Q. (2023). Effect of K‑line on posterior cervical surgery versus anterior cervical surgery in patients with multi-level ossification of posterior longitudinal ligament. European Spine Journal , 32 (7), 2396–2401. https://doi.org/10.1007/s00586-023-07736-y Liu, X., Min, S., Zhang, H., Zhou, Z., Wang, H., & Jin, A. (2014). Anterior corpectomy versus posterior laminoplasty for multilevel cervical myelopathy: a systematic review and meta-analysis. European Spine Journal , 23 (2), 362–372. https://doi.org/10.1007/s00586-013-3043-7 Montano, N., Ricciardi, L., & Olivi, A. (2019). Comparison of Anterior Cervical Decompression and Fusion versus Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy: A Meta-Analysis of Clinical and Radiological Outcomes. World Neurosurgery , 130 , 530-536.e2. https://doi.org/10.1016/j.wneu.2019.06.144 Paracino, R., Fasinella, M. R., Mancini, F., Marini, A., & Dobran, M. (2021). Review of laminoplasty versus laminectomy in the surgical management of cervical spondylotic myelopathy. Surgical Neurology International , 12 , 44. https://doi.org/10.25259/SNI_788_2020 Pescatori, L., Tropeano, M. P., Visocchi, M., Grasso, G., & Ciappetta, P. (2020). Cervical Spondylotic Myelopathy: When and Why the Cervical Corpectomy? World Neurosurgery , 140 , 548–555. https://doi.org/10.1016/j.wneu.2020.03.100 Seng, C., Tow, B. P. B., Siddiqui, M. A., Srivastava, A., Wang, L., Yew, A. K. S., Yeo, W., Khoo, S. H. R., Balakrishnan, N. M. S., Bin Abd Razak, H. R., Chen, J. L. T., Guo, C. M., Tan, S. B., & Yue, W.-M. (2013). Surgically treated cervical myelopathy: a functional outcome comparison study between multilevel anterior cervical decompression fusion with instrumentation and posterior laminoplasty. The Spine Journal , 13 (7), 723–731. https://doi.org/10.1016/j.spinee.2013.02.038 TÜRKOĞLU, M. E., GÜLMEZ, A., ELBİR, Ç., ŞAHİN, Ö. S., HANALİOĞLU, Ş., DİNÇ, S., TÖNGE, Ç., & KALAN, M. (2021). Surgical outcome of laminoplasty for cervical spondylotic myelopathy: a single- institution experience. TURKISH JOURNAL OF MEDICAL SCIENCES , 51 (6), 2887–2896. https://doi.org/10.3906/sag-2102-308 Ud Din Hoti, Y., Aziz, A., Ishaque, K., Abbas, S., & Salah Ud Din, T. (2018). Clinical Outcome Of Laminoplasty In Cervical Myelopathy. Journal of the College of Physicians and Surgeons Pakistan , 28 (6), 466–469. https://doi.org/10.29271/jcpsp.2018.06.466 Williams, J., D’Amore, P., Redlich, N., Darlow, M., Suwak, P., Sarkovich, S., & Bhandutia, A. K. (2022). Degenerative Cervical Myelopathy. Orthopedic Clinics of North America , 53 (4), 509–521. https://doi.org/10.1016/j.ocl.2022.05.007 Zhong, H., Xu, C., Wang, R., Wu, X., Wu, H., Sun, B., Wang, X., Chen, H., Shen, X., & Yuan, W. (2023). Anterior cervical discectomy and fusion, open-door laminoplasty, or laminectomy with fusion: Which is the better treatment for four-level cervical spondylotic myelopathy? Frontiers in Surgery , 9 . https://doi.org/10.3389/fsurg.2022.1065103 Tables Tables 1 and 2 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5380744","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":378294975,"identity":"93049ce3-f2b4-49a7-9fe6-a93975236836","order_by":0,"name":"Mehmet Besir SURME","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA30lEQVRIiWNgGAWjYDACCSBOgDAZHwAJHj5StDAbgLSwEaUFCtjAbIJadGc3H/7wcE9d4vZph49Vfs2xk2FjYH746AYeLWZ3jqVJJDw7nDjndlrabdltyUCHsRkb5+DTciPHjCHhwIHEGdI5ZrcltzEDtfCwSePXkv/5Q8KBOqCW/G/FktvqidGSwyCRcIAZZAsb48dth4nQcueYGVDLYeMZ0mnG0ozbjvOwMRPyy+3mxx9/HKiTnSGd/PDjz23V9vzszQ8f49OCAph5wCSxykGA8QcpqkfBKBgFo2DEAACbWUlTvcJ+0AAAAABJRU5ErkJggg==","orcid":"","institution":"Eskişehir City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Mehmet","middleName":"Besir","lastName":"SURME","suffix":""},{"id":378294976,"identity":"0ac665e8-16b1-41c8-9514-e39361357286","order_by":1,"name":"Bekir AKGÜN","email":"","orcid":"","institution":"Fırat Üniversitesi Hastanesi","correspondingAuthor":false,"prefix":"","firstName":"Bekir","middleName":"","lastName":"AKGÜN","suffix":""},{"id":378294977,"identity":"b76648ca-0991-47af-a540-c9022ab783ef","order_by":2,"name":"Efecan CEKIC","email":"","orcid":"","institution":"Polatlı Duatepe City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Efecan","middleName":"","lastName":"CEKIC","suffix":""},{"id":378294978,"identity":"5cd03e16-d30a-48ef-ba9a-b42f9e4d2c52","order_by":3,"name":"Mehmet ISCI","email":"","orcid":"","institution":"Fırat Üniversitesi Hastanesi","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"ISCI","suffix":""},{"id":378294979,"identity":"d3a87b5e-6c3a-4c13-9692-4f1e514f2317","order_by":4,"name":"Hanefi YILDIRIM","email":"","orcid":"","institution":"Fırat Üniversitesi Hastanesi","correspondingAuthor":false,"prefix":"","firstName":"Hanefi","middleName":"","lastName":"YILDIRIM","suffix":""}],"badges":[],"createdAt":"2024-11-03 06:23:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5380744/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5380744/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":70507584,"identity":"6078bc79-68d5-4275-a801-4406fafbcd4f","added_by":"auto","created_at":"2024-12-03 23:53:45","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":205077,"visible":true,"origin":"","legend":"\u003cp\u003eDemonstration of our radiological measurements in the cervical region according to the Cervical Spine Research Society\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA:\u003c/strong\u003e Cobb Angle \u003cstrong\u003eB:\u003c/strong\u003e Harrison Posterior Tangent Curve \u003cstrong\u003eC: \u003c/strong\u003eJackson Stress \u003cstrong\u003eD: \u003c/strong\u003eCranial Tilt \u003cstrong\u003eE:\u003c/strong\u003e Sagittal Vertical Axis \u003cstrong\u003eF:\u003c/strong\u003eCervical Tilt\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5380744/v1/49b79d959fbecbc796a140ea.png"},{"id":70507586,"identity":"6be97d48-87b7-4a84-bf68-1c0b5ec71f80","added_by":"auto","created_at":"2024-12-03 23:53:46","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":49113,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of different radiological parameters in pre-operative and post-operative patient groups.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea-b)\u003c/strong\u003e Harrison Post, \u003cstrong\u003ec-d)\u003c/strong\u003e Sagittal Vertical Axis, and \u003cstrong\u003ee-f) \u003c/strong\u003eCranial Tilt values in corpectomy and laminoplasty approaches.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5380744/v1/299b9d147ebf6fecfb17e7bd.png"},{"id":70508056,"identity":"0bf6faa5-156f-4e21-ad56-82d35c8e92ed","added_by":"auto","created_at":"2024-12-04 00:01:45","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":41119,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of corpectomy and laminoplasty approaches in terms of effectiveness. The ratio of post-operative to pre-operative (PostOp./PreOp.) values.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ea)\u003c/strong\u003e Harrison Post, \u003cstrong\u003eb)\u003c/strong\u003e Sagittal Vertical Axis, and \u003cstrong\u003ec)\u003c/strong\u003e Cranial Tilt\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5380744/v1/ac2bcdeeab5e948dd20f22ac.png"},{"id":73005437,"identity":"1549a1b0-aa69-4b9f-a4e6-5e56137898cb","added_by":"auto","created_at":"2025-01-05 19:46:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":703159,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5380744/v1/adb2e2b3-d061-4d72-abea-d11b2085e8b8.pdf"},{"id":70507583,"identity":"a7f684ee-2f58-4978-b1a3-0e8ecec62104","added_by":"auto","created_at":"2024-12-03 23:53:45","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":17396,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-5380744/v1/82acd30ef22d5a98f2207961.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparative Analysis of Anterior Corpectomy versus Laminoplasty Efficacy in Radiological Outcomes for Cervical Spondylotic Myelopathy Treatment","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCervical Spondylotic Myelopathy (CSM) stems from chronic cervical spinal cord compression due to degenerative changes, leading to functional deterioration and diminished quality of life(Kalsi-Ryan et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). It represents a significant clinical entity characterized by a constellation of symptoms, including neck pain, spasticity, weakness, and sensorimotor deficits, attributable to the compression of the cervical spinal cord(Iyer et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Adult spinal cord impairment frequently necessitates surgery to arrest neurological deterioration and possibly ameliorate myelopathy(Williams et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe advent of surgical treatments for CSM has traditionally revolved around two mainstays: anterior corpectomy and laminoplasty(Edwards et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Seng et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Anterior corpectomy aims at decompression by directly removing the compressive pathology and stabilizing the segment through spinal fusion(Pescatori et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In contrast, laminoplasty seeks to expand the spinal canal indirectly by remodeling the laminae, thus preserving motion and obviating the need for fusion(Paracino et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Each approach, anterior and posterior, brings unique benefits and challenges, and the decision-making process in selecting an appropriate surgical technique is often influenced by many factors, including the severity of compression, the number of levels involved, and the alignment of the cervical spine(Montano et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eModern medical advancements necessitate a rigorous reevaluation of surgical methods, mainly focusing on radiological assessments to gauge the efficacy of interventions such as anterior corpectomy and laminoplasty. Our study, distinct from other clinical evaluations, emphasizes radiological outcomes by employing comprehensive statistical analyses to ensure precise interpretation of postoperative improvements, thereby reinforcing the significance of imaging in assessing these surgical techniques.\u003c/p\u003e \u003cp\u003eThis research is particularly critical given the context of an aging population and the resulting increase in degenerative spinal conditions. By evaluating the postoperative improvements across various radiological parameters, including the Harrison posterior tangent curve (Harrison Post), sagittal vertical axis (SVA), and cranial tilt, we endeavored to elucidate the comparative effectiveness of the anterior corpectomy and laminoplasty to inform clinical decisions and optimize patient outcomes in the treatment of CSM.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eThis study evaluated the radiological improvements in patients undergoing anterior corpectomy and laminoplasty to treat CSM. A retrospective analysis of the clinical data was conducted on a cohort of patients who underwent either surgical approach. Informed consent was obtained from all patients in the study, and patient anonymity was preserved throughout the analysis. Our study received ethical approval on 27/02/2023 with decision Number is 9.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatient Selection and Data Collection\u003c/h2\u003e \u003cp\u003eThe study retrospectively analyzed 45 patients, consisting of 33 men and 12 women, who underwent surgical treatment for CSM between 2016 and 2022. These patients were treated with either anterior corpectomy (21 patients) or laminoplasty (24 patients).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eRadiological Assessment\u003c/h3\u003e\n\u003cp\u003ePreoperative and 6-month postoperative CT scans and/or MR images were analyzed. Preoperative and postoperative sixth-month radiological data were collected from medical records, including parameters such as Harrison posterior tangent curve (Harrison Post), Sagittal Vertical Axis (SVA), Cranial Tilt, Cobb Angle, Jackson Stress curve, and cervical tilt, which is depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Measurements were standardized according to established protocols to ensure consistency across the evaluations. The radiological assessment was measured using criteria the Cervical Spine Research Society set.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eThe statistical analyses were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard error of the mean (SEM). An unpaired t-test (one-sided p-value) was used to compare parameters between the preoperative and postoperative groups. The effectiveness of corpectomy and laminoplasty approaches was evaluated using the PostOp./PreOp\u0026mdash;the ratio from different parameters. The comparison was performed using GraphPad Prism 8.01 (GraphPad Software, USA) software. The degree of significance was denoted as * p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 and ** p\u0026thinsp;\u0026lt;\u0026thinsp;0.01.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eOur statistical analysis compared the radiological improvements in CSM patients who underwent either anterior corpectomy or laminoplasty. The data was subdivided into two groups based on the surgical approach they received. We evaluated multiple parameters, including the Harrison posterior tangent curve (Harrison Post), Sagittal Vertical Axis (SVA), Cranial Tilt, Cobb Angle, and Jackson Stress test. These were measured preoperatively and six months post-operation.\u003c/p\u003e\n\u003cp\u003eThe corpectomy group significantly reduced the Harrison Post measurement from preoperative 24.32 ± 2.47 to postoperative 17.42 ± 2.52 (*p* = 0.0295). Similarly, the laminoplasty group reduced from 28.42 ± 2.28 to 21.58 ± 2.45 (*p* = 0.0242). There was a statistically significant increase in both groups postoperatively for the Sagittal Vertical Axis. The corpectomy group changed from 19.90 ± 2.14 to 28.10 ± 2.66 (*p* = 0.0107), and the laminoplasty group from 18.21 ± 2.43 to 25.42 ± 2.62 (*p* = 0.0250). Cranial Tilt also increased significantly after surgery in both groups, with the corpectomy group changing from 6.61 ± 1.18 to 12.24 ± 1.62 (**p** \u0026lt; 0.01) and the laminoplasty group from 6.83 ± 1.39 to 12.13 ± 1.37 (**p** \u0026lt; 0.01). However, Cobb Angle, Jackson Stress, and cervical tilt changes did not show statistical significance in either group, as presented in \u003cstrong\u003eTable 1\u003c/strong\u003e and \u003cstrong\u003eFigure 2\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eWhen comparing the effectiveness of the two approaches by evaluating the ratio of post-operative to pre-operative values, no statistically significant differences were found between the two surgical techniques. Harrison Post ratio was 0.91 ± 0.14 for corpectomy and 0.94 ± 0.10 for laminoplasty (p = 0.4220). The Sagittal Vertical Axis ratio was 1.58 ± 0.14 for corpectomy and 1.64 ± 0.22 for laminoplasty (p = 0.4216). The cranial Tilt ratio was 3.01 ± 0.56 for corpectomy and 3.22 ± 0.82 for laminoplasty (p = 0.4172), demonstrated in \u003cstrong\u003eTable 2\u003c/strong\u003e and \u003cstrong\u003eFigure 3\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eThese results suggest that while both surgical techniques effectively alter the radiological parameters in the treatment of CSM, there is no clear superiority of one method over the other regarding the radiological outcomes measured.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe management of cervical spondylotic myelopathy (CSM) has evolved to include a spectrum of surgical interventions tailored to the complexity of spinal pathology and patient-specific anatomical considerations. Anterior corpectomy has been validated for significant neurological recovery, particularly in cases involving fewer segments and multilevel ossification of the posterior longitudinal ligament(Fessler et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e1998\u003c/span\u003e; Lee et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). Despite these advantages, anterior corpectomy is associated with higher reoperation rates, longer operation times, and increased blood loss, suggesting a careful patient selection process(Huang et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; X. Liu et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn the other end of the spectrum, posterior laminoplasty remains the cornerstone for multilevel cervical myelopathy, particularly when the number of segments involved precludes an anterior approach(J. Liu et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; T\u0026Uuml;RKOĞLU et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Ud Din Hoti et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). However, when local kyphotic deformity, OPLL, or segmental instability complicates the clinical picture, standalone laminoplasty may not suffice(Badhiwala et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eZhong et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) suggested that open-door laminoplasty (LAMP) may be advantageous for preserving cervical mobility and minimizing postoperative complications in treating four-level cervical spondylotic myelopathy. While all three procedures demonstrated improvements in the JOA, NDI, and VAS scores, LAMP showed a slight reduction in range of motion, a critical factor for postoperative quality of life. Given these outcomes, LAMP could be considered the preferred option when surgical goals prioritize mobility preservation and lower complication rates(Zhong et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e The literature review by K. Bridges et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) introduces a compelling case for the amalgamation of laminoplasty with posterior fusion in such intricate cases. This combined approach addresses the dual objectives of decompression and stabilization, which are paramount in scenarios in which traditional laminoplasty may fall short. Specifically, in the presence of local kyphotic deformity or segmental instability, the additional fusion can mitigate the risk of postoperative deformity progression and ensure spinal cord decompression(Bridges et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur study complements the findings of Li et al., in which clinical characteristics and MRI indicators were correlated with surgical results(Li et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). While Li et al. identified factors such as the duration of symptoms and specific MRI signal changes as predictive of outcomes, our research adds a quantitative dimension to the assessment process. Our investigation into the predictive radiological parameters for CSM surgery outcomes aligns with the work of Khan et al., who elucidated the role of MRI in assessing tissue injury within the cervical spinal cord(Khan et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The concurrence between our studies lies in recognizing MRI's diagnostic power, with our research providing actionable insights through measurable spinal changes pre-and post-surgery. This combined approach enriches the understanding of CSM pathology and fosters a more informed surgical decision-making process that can significantly improve patient management and recovery. Together, these studies suggest a multifaceted predictive model that combines clinical presentations with a robust radiological assessment to enhance the prognostic accuracy of CSM surgery.\u003c/p\u003e \u003cp\u003eOur study is a pivotal reference for surgical decision-making and patient follow-up in the intricate landscape of CSM treatment. By underpinning the prognostic value of radiological assessments, we provide a clear rationale for incorporating specific radiological parameters into the standard preoperative and postoperative evaluation framework. These parameters are critical indicators correlating with patient recovery and quality of life. Their integration into clinical practice allows for a nuanced approach beyond subjective assessment, offering a data-driven strategy that refines the choice of surgical technique and the anticipated outcomes.\u003c/p\u003e \u003cp\u003eOur findings mainly highlight the importance of personalized care in CSM management. Despite its potential for significant neurological improvement, anterior corpectomy must be judiciously considered against its higher associated risks, as our research indicates. Alternatively, posterior approaches, especially those combined with fusion, have emerged as a compelling option for more complex cases in which structural stability and alignment are paramount. This evidence-based approach ensures that surgical plans are not static but evolve in response to patient-specific needs and the dynamic nature of spinal pathologies.\u003c/p\u003e \u003cp\u003eThe retrospective design and modest cohort size of our study limit its scope, potentially introducing selection bias and constraining the statistical robustness of the findings. Future research should address these limitations by employing a prospective, multicenter approach with a larger patient population, extending the investigation to encompass long-term clinical outcomes, patient quality of life, and the utility of advanced imaging modalities to deepen the understanding of cervical spondylotic myelopathy treatment efficacy.\u003c/p\u003e \u003cp\u003eThe ultimate goal of our study was to enhance the surgical treatment framework for CSM by advocating a patient-centered bespoke plan. This plan, informed by our validated radiological parameters, aimed to maximize neurological recovery while minimizing complications. This underscores the need for a multidisciplinary team to manage CSM, a condition that demands as much precision in its surgical intervention as it does compassion in its aftercare. Our research lays the groundwork for such an approach, guiding the surgical community toward more informed and effective treatment paradigms.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eOur comprehensive radiological assessment provides a valuable perspective on the efficacy of anterior corpectomy and laminoplasty in managing cervical spondylotic myelopathy (CSM). While both surgical techniques demonstrated significant improvements in parameters such as the Harrison posterior tangent curve, Sagittal Vertical Axis, and Cranial Tilt, our findings suggest no distinct superiority of one procedure. This complements the work of Li et al., which correlates clinical characteristics with MRI predictors for surgical outcomes, and the research by Khan et al., which highlighted MRI's utility of MRI in quantifying spinal tissue injury. These studies underscore the need to integrate clinical insights with advanced imaging analytics to inform surgical strategies and patient-specific care. Surgical decision-making and prognostic follow-up processes must be guided by balanced consideration of radiological data and clinical presentation to provide patients with the most favorable prognostic outcomes and quality of life post-surgery.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical\u003c/strong\u003e \u003cstrong\u003eApproval :\u0026nbsp;\u003c/strong\u003eOur study received ethical approval on 27/02/2023 with decision Number is 9.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting\u003c/strong\u003e \u003cstrong\u003einterests:\u003c/strong\u003e There are no any competing interests between the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors'\u003c/strong\u003e \u003cstrong\u003econtributions:\u0026nbsp;\u003c/strong\u003eMehmet Besir SURME \u0026nbsp;and Mehmet ISCI wrote the main manuscript text and \u0026nbsp;Efecan CEKIC , Bekir AKGUN and Hanefi YILDIRIM \u0026nbsp;prepared figures 1-3 and tables All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThere is no funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability\u003c/strong\u003e \u003cstrong\u003eof data and materials:\u0026nbsp;\u003c/strong\u003eThere is no materials\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBadhiwala, J. H., Ellenbogen, Y., Khan, O., Nouri, A., Jiang, F., Wilson, J. R. F., Jaja, B., Witiw, C. D., Nassiri, F., Fehlings, M. G., \u0026amp; Wilson, J. R. (2020). Comparison of the Inpatient Complications and Health Care Costs of Anterior versus Posterior Cervical Decompression and Fusion in Patients with Multilevel Degenerative Cervical Myelopathy: A Retrospective Propensity Score\u0026ndash;Matched Analysis. \u003cem\u003eWorld Neurosurgery\u003c/em\u003e, \u003cem\u003e134\u003c/em\u003e, e112\u0026ndash;e119. https://doi.org/10.1016/j.wneu.2019.09.132\u003c/li\u003e\n\u003cli\u003eBridges, K. J., Simpson, L. N., Bullis, C. L., Rekito, A., Sayama, C. M., \u0026amp; Than, K. D. (2018). Combined Laminoplasty and Posterior Fusion for Cervical Spondylotic Myelopathy Treatment: A Literature Review. \u003cem\u003eAsian Spine Journal\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(3), 446\u0026ndash;458. https://doi.org/10.4184/asj.2018.12.3.446\u003c/li\u003e\n\u003cli\u003eEdwards, C. C., Heller, J. G., \u0026amp; Murakami, H. (2002). Corpectomy Versus Laminoplasty for Multilevel Cervical Myelopathy. \u003cem\u003eSpine\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(11), 1168\u0026ndash;1175. https://doi.org/10.1097/00007632-200206010-00007\u003c/li\u003e\n\u003cli\u003eFessler, R. G., Steck, J. C., \u0026amp; Giovanini, M. A. (1998). Anterior Cervical Corpectomy for Cervical Spondylotic Myelopathy. \u003cem\u003eNeurosurgery\u003c/em\u003e, \u003cem\u003e43\u003c/em\u003e(2), 257\u0026ndash;265. https://doi.org/10.1097/00006123-199808000-00044\u003c/li\u003e\n\u003cli\u003eHuang, D., Du, X., Liang, H., Hu, W., Hu, H., \u0026amp; Cheng, X. (2016). Anterior corpectomy versus posterior laminoplasty for the treatment of multilevel cervical myelopathy: A meta-analysis. \u003cem\u003eInternational Journal of Surgery\u003c/em\u003e, \u003cem\u003e35\u003c/em\u003e, 21\u0026ndash;27. https://doi.org/10.1016/j.ijsu.2016.09.008\u003c/li\u003e\n\u003cli\u003eIyer, A., Azad, T. D., \u0026amp; Tharin, S. (2016). Cervical Spondylotic Myelopathy. \u003cem\u003eClinical Spine Surgery: A Spine Publication\u003c/em\u003e, \u003cem\u003e29\u003c/em\u003e(10), 408\u0026ndash;414. https://doi.org/10.1097/BSD.0000000000000397\u003c/li\u003e\n\u003cli\u003eKalsi-Ryan, S., Karadimas, S. K., \u0026amp; Fehlings, M. G. (2013). Cervical Spondylotic Myelopathy. \u003cem\u003eThe Neuroscientist\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(4), 409\u0026ndash;421. https://doi.org/10.1177/1073858412467377\u003c/li\u003e\n\u003cli\u003eKhan, A. F., Haynes, G., Mohammadi, E., Muhammad, F., Hameed, S., \u0026amp; Smith, Z. A. (2023). Utility of MRI in Quantifying Tissue Injury in Cervical Spondylotic Myelopathy. \u003cem\u003eJournal of Clinical Medicine\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(9), 3337. https://doi.org/10.3390/jcm12093337\u003c/li\u003e\n\u003cli\u003eLee, S.-H., Ahn, Y., \u0026amp; Lee, J. H. (2008). Laser-Assisted Anterior Cervical Corpectomy versus Posterior Laminoplasty for Cervical Myelopathic Patients with Multilevel Ossification of the Posterior Longitudinal Ligament. \u003cem\u003ePhotomedicine and Laser Surgery\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e(2), 119\u0026ndash;127. https://doi.org/10.1089/pho.2007.2110\u003c/li\u003e\n\u003cli\u003eLi, X.-Y., Lu, S.-B., Sun, X.-Y., Kong, C., Guo, M.-C., Sun, S.-Y., Ding, J.-Z., \u0026amp; Yang, Y.-M. (2018). Clinical and magnetic resonance imaging predictors of the surgical outcomes of patients with cervical spondylotic myelopathy. \u003cem\u003eClinical Neurology and Neurosurgery\u003c/em\u003e, \u003cem\u003e174\u003c/em\u003e, 137\u0026ndash;143. https://doi.org/10.1016/j.clineuro.2018.09.003\u003c/li\u003e\n\u003cli\u003eLiu, J., Wang, J., Ding, Z., Hai, Y., Zhang, Y., Kang, N., \u0026amp; Wang, Q. (2023). Effect of K‑line on posterior cervical surgery versus anterior cervical surgery in patients with multi-level ossification of posterior longitudinal ligament. \u003cem\u003eEuropean Spine Journal\u003c/em\u003e, \u003cem\u003e32\u003c/em\u003e(7), 2396\u0026ndash;2401. https://doi.org/10.1007/s00586-023-07736-y\u003c/li\u003e\n\u003cli\u003eLiu, X., Min, S., Zhang, H., Zhou, Z., Wang, H., \u0026amp; Jin, A. (2014). Anterior corpectomy versus posterior laminoplasty for multilevel cervical myelopathy: a systematic review and meta-analysis. \u003cem\u003eEuropean Spine Journal\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(2), 362\u0026ndash;372. https://doi.org/10.1007/s00586-013-3043-7\u003c/li\u003e\n\u003cli\u003eMontano, N., Ricciardi, L., \u0026amp; Olivi, A. (2019). Comparison of Anterior Cervical Decompression and Fusion versus Laminoplasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy: A Meta-Analysis of Clinical and Radiological Outcomes. \u003cem\u003eWorld Neurosurgery\u003c/em\u003e, \u003cem\u003e130\u003c/em\u003e, 530-536.e2. https://doi.org/10.1016/j.wneu.2019.06.144\u003c/li\u003e\n\u003cli\u003eParacino, R., Fasinella, M. R., Mancini, F., Marini, A., \u0026amp; Dobran, M. (2021). Review of laminoplasty versus laminectomy in the surgical management of cervical spondylotic myelopathy. \u003cem\u003eSurgical Neurology International\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 44. https://doi.org/10.25259/SNI_788_2020\u003c/li\u003e\n\u003cli\u003ePescatori, L., Tropeano, M. P., Visocchi, M., Grasso, G., \u0026amp; Ciappetta, P. (2020). Cervical Spondylotic Myelopathy: When and Why the Cervical Corpectomy? \u003cem\u003eWorld Neurosurgery\u003c/em\u003e, \u003cem\u003e140\u003c/em\u003e, 548\u0026ndash;555. https://doi.org/10.1016/j.wneu.2020.03.100\u003c/li\u003e\n\u003cli\u003eSeng, C., Tow, B. P. B., Siddiqui, M. A., Srivastava, A., Wang, L., Yew, A. K. S., Yeo, W., Khoo, S. H. R., Balakrishnan, N. M. S., Bin Abd Razak, H. R., Chen, J. L. T., Guo, C. M., Tan, S. B., \u0026amp; Yue, W.-M. (2013). Surgically treated cervical myelopathy: a functional outcome comparison study between multilevel anterior cervical decompression fusion with instrumentation and posterior laminoplasty. \u003cem\u003eThe Spine Journal\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(7), 723\u0026ndash;731. https://doi.org/10.1016/j.spinee.2013.02.038\u003c/li\u003e\n\u003cli\u003eT\u0026Uuml;RKOĞLU, M. E., G\u0026Uuml;LMEZ, A., ELBİR, \u0026Ccedil;., ŞAHİN, \u0026Ouml;. S., HANALİOĞLU, Ş., DİN\u0026Ccedil;, S., T\u0026Ouml;NGE, \u0026Ccedil;., \u0026amp; KALAN, M. (2021). Surgical outcome of laminoplasty for cervical spondylotic myelopathy: a single- institution experience. \u003cem\u003eTURKISH JOURNAL OF MEDICAL SCIENCES\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e(6), 2887\u0026ndash;2896. https://doi.org/10.3906/sag-2102-308\u003c/li\u003e\n\u003cli\u003eUd Din Hoti, Y., Aziz, A., Ishaque, K., Abbas, S., \u0026amp; Salah Ud Din, T. (2018). Clinical Outcome Of Laminoplasty In Cervical Myelopathy. \u003cem\u003eJournal of the College of Physicians and Surgeons Pakistan\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(6), 466\u0026ndash;469. https://doi.org/10.29271/jcpsp.2018.06.466\u003c/li\u003e\n\u003cli\u003eWilliams, J., D\u0026rsquo;Amore, P., Redlich, N., Darlow, M., Suwak, P., Sarkovich, S., \u0026amp; Bhandutia, A. K. (2022). Degenerative Cervical Myelopathy. \u003cem\u003eOrthopedic Clinics of North America\u003c/em\u003e, \u003cem\u003e53\u003c/em\u003e(4), 509\u0026ndash;521. https://doi.org/10.1016/j.ocl.2022.05.007\u003c/li\u003e\n\u003cli\u003eZhong, H., Xu, C., Wang, R., Wu, X., Wu, H., Sun, B., Wang, X., Chen, H., Shen, X., \u0026amp; Yuan, W. (2023). Anterior cervical discectomy and fusion, open-door laminoplasty, or laminectomy with fusion: Which is the better treatment for four-level cervical spondylotic myelopathy? \u003cem\u003eFrontiers in Surgery\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e. https://doi.org/10.3389/fsurg.2022.1065103\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 and 2 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cervical Spondylotic Myelopathy, Cervical Radiological Measurements, Corpektomy, Laminoplasty","lastPublishedDoi":"10.21203/rs.3.rs-5380744/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5380744/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis study aims to assess the radiological outcomes of anterior corpectomy compared to laminoplasty in treating Cervical Spondylotic Myelopathy (CSM), focusing on postoperative improvements in key imaging metrics.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMaterials and Methods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA retrospective cohort analysis evaluated 45 patients diagnosed with CSM who underwent anterior corpectomy (21 patients) or laminoplasty (24 patients). Radiological outcomes were measured by comparing preoperative and 6-month postoperative CT and MRI scans, focusing on the Harrison posterior tangent curve, sagittal vertical axis (SVA), cranial tilt, cervical tilt, Jackson stress curve and cobb angle.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe study found statistically significant improvements in Harrison posterior tangent curve, SVA and cranial tilt measurements for both surgical methods. No significant differences were observed between the two surgical techniques when comparing the ratio of post-operative to pre-operative values.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eBoth anterior corpectomy and laminoplasty were effective in altering radiological parameters in the treatment of CSM, with no significant difference in efficacy between the two techniques. These findings underscore the importance of a tailored approach to surgical intervention in CSM, with decisions based on individual patient anatomy and clinical presentation. Further studies with larger patient populations are needed to confirm these results and establish standardized radiological benchmarks for surgical outcomes in CSM treatment.\u003c/p\u003e","manuscriptTitle":"Comparative Analysis of Anterior Corpectomy versus Laminoplasty Efficacy in Radiological Outcomes for Cervical Spondylotic Myelopathy Treatment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-03 23:53:40","doi":"10.21203/rs.3.rs-5380744/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"57a18a46-6e0c-487b-9751-61d5ac80e0c8","owner":[],"postedDate":"December 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-05T19:38:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-03 23:53:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5380744","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5380744","identity":"rs-5380744","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}