الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cervical spondylotic myelopathy (CSM) is a chronic progressive spinal compression that usually accompanies age-related degeneration of the cervical spine. Due to the progressive nature of the condition, most spinal surgeons agree that surgery is the optimal line of management, there is considerable debate, however, over the best approach. Certain factors must be considered when deciding the best approach for a given patient, namely, source of compression, number of segments, sagittal alignment, specific anatomy, patient’s risk factors and/or history of previous neck surgeries.
Anterior approaches are generally preferred when the compression involves three or fewer levels or when there is a kyphotic alignment, it allows for direct decompression of anterior pathologies. Posterior approaches are generally reserved for three or more compression levels, decompression is achieved either directly if the compressive element is posteriorly located or indirectly by allowing the cervical cord to drift posteriorly away from the compressive anterior pathologies.
This study included 60 patients with cervical spondylotic myelopathy assigned to four groups. group A1 patients underwent ACDF only, group A2 underwent ACDF with plating, group B1 underwent laminectomy only and group B2 underwent laminectomy with lateral mass fusion. All groups completed 12 months follow-up duration. The aim of the study was to evaluate and compare two techniques of anterior approaches versus two techniques of posterior approaches in management of CSM regarding patients functional, radiological outcomes and quality of life.
Our results revealed that all the four surgical techniques were associated with functional improvement compared to preoperative parameters. Anterior approaches were associated with better restoration of lordosis and better overall quality of life than posterior approaches. We recommend designing randomized controlled trials in the future with longer follow-up periods to address long-term outcomes and/or complications.