Microscopic Anterior Cervical Oblique Corpectomy for Management of Cervical Spondylotic Myelopathy: A Retrospective Study

Background: Cervical spondylotic myelopathy (CSM) of-ten requires surgical decompression. Traditional fusion tech-niques limit mobility and carry graft-related risks. Microscopic oblique corpectomy (MOC) offers a motion-preserving alter-native. Aim of Study: To assess clinical outcomes of microscopic anterior cervical oblique corpectomy (also known as oblique cervical corpectomy, OCC) in patients with CSM) or myelo-radiculopathy. Patients and Methods: A retrospective analysis was per-formed on 30 patients with CSM or CSM with radiculopathy who were refractory to ≥6 months of conservative manage-ment. All had multilevel ventral compression with preserved alignment and underwent MOC at a single institution (2017– 2024). Outcomes included the modified Japanese Orthopaedic Association (mJOA) score, Nurick grade, Visual Analog Scale (VAS) for neck pain, Neck Disability Index (NDI), complica-tion rates, and radiographic stability over 6 months. Statistical analysis employed paired t-tests and Fisher’s exact test (SPSS v25, significance p<0.05). Results: Mean age was 55.3±7.8 years (Male: Female = 1.5:1). Significant postoperative improvements were observed: mJOA increased from 10.33±2.4 to 16.0±2.04 (p<0.001, mean recovery rate 74.4%), VAS decreased from 7.2±1.1 to 3.1±0.9 (p<0.001), and NDI improved from 68.5%±6.7% to 28.3%± 5.2% (p<0.001). Excellent or good outcomes were achieved in 83.3% of patients. The most frequently decompressed level was C5–C6 (41.2%). Complications occurred in 13.3% (n=4): compressive hematoma (1, evacuated), transient Horner’s syndrome (1), dural tear (1, repaired intraoperatively), and de-layed instability (1, later requiring fusion). Radiographic sta-bility was maintained in 96.7% of patients at 6 months. Conclusion: MOC is a safe, effective, and motion-preserv-ing technique for cervical spondylotic myelopathy. It achieves anterior decompression without fusion or instrumentation, maintaining spinal stability while minimizing complications. MOC offers favorable outcomes in appropriately selected patients with a short recovery period, though it requires mi-crosurgical expertise and careful anatomical dissection due to technical complexity.