Subject Area
Cervical spine, Degenerative
Article Type
Original Study
Abstract
Background data: Posterior cervical laminectomy and lateral mass screw-rod fusion techniques were classically recommended in flexible sagittal cervical alignment relying on indirect decompression via posterior cord shift. Purpose: This study aims to investigate the efficacy of posterior cervical laminectomy with lateral mass screw-rod fixation for treating multisegmental cervical spondylotic myelopathy with flexible sagittal cervical alignment. Study Design: Prospective clinical cohort study. Patients and Methods: In total, 38 patients with clinically symptomatic M-CSM with instability and/or flexible kyphosis were admitted to our Zagazig university hospitals for posterior cervical laminectomy and lateral mass screw-rod fusion (long-segment instrumented fusion ≥3 segments) and completed the 24-month follow-up period between April 2014 and June 2018 and the last follow-up visit took place in October 2020. Patients were categorized into lordotic, straight, and kyphotic groups according to the shape of the cervical spine curve on a neutral lateral X-ray view. Results: A total of 266 lateral mass screws were inserted in 134 levels in 38 patients (3 levels in 20 patients, 4 levels in 16 patients, and 5 levels in 2 patients), all the patients had a good fusion, and the cervical spine was stable, based on the absence of hardware failure or subsidence. All 38 patients (100%) gained more lordosis with a variable degree according to the preoperative cervical sagittal alignment. The mean percentage of neck pain improvement according to the Visual Analogue Scale (VAS) for the lordotic group was 69.1%, for the straight group was 43.8%, and for the kyphotic group was 15.8%. The mean percentage of neurological function improvement (JOA score) for the lordotic group was 83.17%, for the straight group was 43%, and for the kyphotic group was 17%. The mean percentage of disability improvement (NDI score) for the lordotic group was 47.66%, for the straight group was 24.5%, and for the kyphotic group was 16.66%. Conclusion: Decompressive cervical spine laminectomy with lateral mass screw stabilization is effective in treating multisegmental cervical spondylotic myelopathy with flexible sagittal cervical alignment. (2022ESJ259)
Keywords
lateral mass fusion, cervical myelopathy, spinal fixation, decompressive laminectomy.
How to Cite This Article
Hussein, Mohamed; Abdelrazek, Mohamed A; and Eladawy, Amr
(2022)
"Decompressive Cervical Laminectomy and Lateral Mass Screw-Rod Fusion for Multisegmental Cervical Spondylotic Myelopathy with Flexible Sagittal Cervical Alignment,"
Advanced Spine Journal: Vol. 41
:
Iss.
2
, Article 3.
Available at: https://doi.org/10.57055/2314-8969.1261