Abstract:Objective To compare the effectiveness of anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) in the treatment of two level cervical spondylotic myelopathy. Methods Clinical data of 58 patients with two-level cervical spondylotic myelopathy treated from January 2020 to December 2022 at Nanjing Jiangbei Hospital Affiliated to Xinglin College, Nantong University were retrospectively analyzed. Patients were divided into ACDF group (n=30) and ACCF group (n=28) based on the surgical procedure. Perioperative data (hospitalization time, intraoperative blood loss and operation time), clinical parameters ［neck disability index (NDI) score and visual analog scale (VAS) score］, and imaging data (segmental angle, T1 slope, C_2-7sagittal vertical axis, C_2-7cervical lordosis, and fusion rate) were compared between the two groups.Results The operation time ［（107.38±12.29）min vs (118.37±11.36)min, t=3.529, P＜0.01］ and intraoperative blood loss ［（58.36±24.31）mL vs （77.73±27.51）mL, t=2.846, P＜0.01］ were lower in the ACDF group than in the ACCF group. Both groups showed significantly decreased NDI and VAS scores postoperatively compared to preoperative scores (P＜0.05), but the difference between the two groups was not statistically significant (P＞0.05). The ACDF group showed significant improvements in segmental angle and C_2-7cervical lordosis postoperatively and at the last follow-up, which were greater than those in the ACCF group (P＜0.05). There was no statistically significant difference in T1 slope, C_2-7sagittal vertical, and fusion rate between the two groups (P＞0.05). Conclusion In the treatment of two-level cervical spondylotic myelopathy, ACDF has less surgical trauma than ACCF and is more advantageous in restoring cervical lordosis. For cases without significant bony spinal cord compression, ACDF is a preferable surgical option for two-level cervical spondylotic myelopathy.