Four-level cervical corpectomy

Study Design. Retrospective analysis of 31 cases of cervical spondylotic myelopathy treated by four-level subaxial cervical corpectomy. Objective. To determine whether extremes of anterior decompression and fusion have inordinate or unique levels of morbidity. Summary of Background Data. There is a paucity of data on experience with four-level corpectomy. However, counsel against such surgery can be found, Materials and Methods. The records and studies of 31 consecutive cases of cervical spondylotic myelopathy, treated by four-level corpectomy, were retrospectively analyzed. Patients in 26 cases were observed longer than 2 years. No hardware was used in the procedures. External orthosis, worn for 6 months, was a Philadelphia-type collar in 25 patients and a halo vest in 6. Results. Three patients died within 3 weeks of surgery (9.7%). Delayed radiculopathy occurred in four patients after surgery, three had acute graft complications, and one had pseudomeningocele, for a morbidity rate of 25.8%. There was no infection or worsened myelopathy. Conclusions. No unique morbidity is associated with extremes of subaxial decompression when compared with surgery of lesser extent.