Abstract：Objective To detect the effects of anterior decompression surgery on unilateral cervical spondylotic amyotrophy.Methods Thirty-five patients with unilateral cervical spondylotic amyotrophy treated by anterior decompression surgery at Spinal Surgery Department in the Third Hospital of Hebei Medical University from January 2005 to January 2014 were retrospectively studied. There were 24 males and 11 females. The mean following time after surgery was 23.2 months, ranged from 12 to 36 months. According to the most severely atrophic muscle, patients were divided into two groups: proximal-type group (n=23) and distal-type group (n=12). Manual muscle test was used to evaluate pre- and postoperative muscle strength. The affected intervertebral level, signal intensity change in the spinal cord, impingemented position of nerve by X-ray, CT and MRI, time and grades of improvement muscle strength were recorded and compared statistically.Results The most commonly affected intervertebral level in proximal-type patients and distal-type patients were C4/5(39.1%, 9/23) and C5/6(10/12), respectively. Signal intensity change in the spinal cord on MRI T2WI was found in 14 patients before surgery. Twenty-four pantients impingemented against the ventral nerve root and 29 patients impingemented against the anterior horn, with 18 patients having both impingemented. The muscle power improvement on manual muscle testing gained 1 or more grades was 82.6%(19/23) in proximal-type group, whereas 5/12 in distal-type group (P=0.022). Fifty-six point five percent of proximal-type group had improvement of muse strength subjectively or objectively, whereas none of distal-type group had improvement, within 15 days after surgery (Z=-3.255, P<0.01).Conclusions Anterior decompression surgery is effective for most of patients with unilateral cervical spondylotic amyotrophy, but compared with the proximal-type patients, the distal-type patients gain inferior and slower postoperative recovery.
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2016, Vol. 21 
