{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:05:48Z","timestamp":1786118748480,"version":"build-2736575974"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Summary of Background Data:<\/jats:title>\n Previous studies comparing the anterior versus posterior approach for the treatment of degenerative cervical myelopathy (DCM) report similar neurological outcomes. Although multilevel DCM is frequently combined with foraminal stenosis, previous studies have analyzed the outcomes of myelopathy without specifically addressing the outcomes of combined radicular symptoms.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To compare the outcomes following anterior and posterior decompressive procedures for DCM combined with multilevel foraminal stenosis.<\/jats:p>\n <\/jats:sec>\n \n Study Design:<\/jats:title>\n A retrospective study.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A cohort of patients with DCM with multilevel foraminal stenosis (>3 levels) who underwent decompression was analyzed. In the anterior group (group A), multilevel anterior cervical decompression and fusion were performed, and the posterior group (group P) consisted of laminoplasty with foraminotomies. Nurick grade, visual analogue scale (VAS) of neck and arm pain, neck disability index (NDI), short-form 36 (SF-36), complications, clinical adjacent segment pathologies (CASP), and additional operations performed were analyzed. C2\u20137 angle and range of motion, and Kellgren grade of radiographic adjacent segment pathology (RASP) were evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 96 patients were enrolled (M:F=53:43, mean age 60.8\u00a0y, A:\n P<\/jats:italic>\n =54:42, mean 36.6\u00a0mo follow-up). All clinical parameters showed significant improvement from preoperative neurological status without significant difference between the 2 groups at the final follow-up. Both RASP grade and incidence of CASP were higher in the anterior group (A: 42.6% vs. P: 19.2%,\n P<\/jats:italic>\n =0.014). The incidence of additional procedures was similar (A: 9.3% vs. P: 16.7%,\n P<\/jats:italic>\n =0.276); however, the etiology was mainly CASP in the anterior group (4\u20135 cases) and persistent radicular symptoms in the posterior group (6\u20137 cases).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Anterior and posterior decompressive surgeries are reliable for the surgical treatment of DCM with multilevel foraminal stenosis and showed similar outcomes for both myelopathy and upper extremity radicular symptoms. The major etiology compromising the clinical outcome was a higher incidence of CASP in the anterior group and persistent or recurrent upper extremity radicular symptoms in the posterior group.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bsd.0000000000002000","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:00:26Z","timestamp":1767200426000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison Between Anterior and Posterior Decompression for Degenerative Cervical Myelopathy With Multilevel Foraminal Stenosis"],"prefix":"10.1097","author":[{"given":"Sang Hun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Sulieman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Chul","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Daniel","family":"Riew","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Columbia University Medical College, Cornell University, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"R1-20251231","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/BRS.0b013e3181b204cc","article-title":"Systematic review of cohort studies comparing surgical treatments for cervical spondylotic myelopathy","volume":"35","author":"Cunningham","year":"2010","journal-title":"Spine (Phila Pa 1976)"},{"key":"R2-20251231","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/01.brs.0000255068.94058.8a","article-title":"Ventral versus dorsal decompression for cervical spondylotic myelopathy: surgeons\u2019 assessment of eligibility for randomization in a proposed randomized controlled trial: results of a survey of the Cervical Spine Research Society","volume":"32","author":"Ghogawala","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"R3-20251231","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1227\/NEU.0b013e31820777cf","article-title":"Comparative effectiveness of ventral vs dorsal surgery for cervical spondylotic myelopathy","volume":"68","author":"Ghogawala","year":"2011","journal-title":"Neurosurgery"},{"key":"R4-20251231","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.3171\/2010.1.FOCUS09253","article-title":"Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome","volume":"28","author":"Cabraja","year":"2010","journal-title":"Neurosurg Focus"},{"key":"R5-20251231","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/00003086-198902000-00010","article-title":"The surgical management of cervical spondylotic radiculopathy and myelopathy","volume":"239","author":"Herkowitz","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"R6-20251231","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1097\/BRS.0b013e3181feeeb2","article-title":"Middle-term results of a prospective comparative study of anterior decompression with fusion and posterior decompression with laminoplasty for the treatment of cervical spondylotic myelopathy","volume":"36","author":"Hirai","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"R7-20251231","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/00007632-199211000-00004","article-title":"Laminoplasty versus subtotal corpectomy. 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