The Spine Journal 25 (2025) 1964−1973
This pooled analysis of 980 DCM patients found that anterior surgical decompression led to greater improvements in quality of life and disability at 1 year compared to posterior surgery, especially in mild cases. Anterior surgery had higher dysphagia risk; posterior surgery had more wound infections and pseudoarthrosis.
• Anterior surgical decompression for degenerative cervical myelopathy (DCM) leads to greater improvements in 1-year patient-reported quality of life and disability compared to posterior decompression.
• The benefit of anterior surgery is especially pronounced in patients with mild DCM, with significantly better outcomes in physical function, disability, and functional status.
• Improvements with anterior surgery are mainly driven by reductions in pain and enhanced ability to engage in recreational and physical activities.
• Dysphagia is more common after anterior surgery, while pseudoarthrosis and wound infections are more frequent after posterior surgery.
• No significant differences were found between the two approaches in mental health outcomes or overall neurological improvement as measured by mJOA and SF36-MCS.
• The study pooled data from three large, prospective multicenter clinical trials, analyzing 980 surgical patients with DCM.
• Results were robust across multiple sensitivity analyses and consistent with recent real-world and meta-analytic studies.
• The findings help inform surgical decision-making but do not dictate a single preferred approach for all patients.
You must be logged in to post a comment.