Cervical posterior implant fixation for multi-segment cervical spondylotic myelopathy: improves symptoms but diminishes cervical range of motion

doi:10.3969/j.issn.2095-4344.2015.22.011

Abstract

Abstract:

BACKGROUND: Cervical Open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation are both procedures that treat cervical spondylotic myelopathy by expanding the space available for the spinal cord. Effectiveness and safety of two operative methods remain unclear.
OBJECTIVE: To investigate the biocompatibility of implant and host between open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation to treat multi-segment cervical spondylotic myelopathy.
METHODS: Data of 117 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments) were retrospectively analyzed. Sixty-five cases underwent open-door laminoplasty with unilateral mass screw fixation (laminoplasty group). Fifty-two cases underwent laminectomy with bilateral mass screw fixation (laminectomy group). Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system and by recovery rate. Cervical curvature index and cervical range of motion were assessed by X-ray films in both groups.
RESULTS AND CONCLUSION: The average follow-up time was 28 months (range 12-59 months) in both groups. No C5 nerve root palsy occurred in the two groups. Japanese Orthopaedic Association scores were greater during final follow-up than pre-fixation in both groups (P < 0.01). No significant difference in Japanese Orthopaedic Association score, recovery rate, and final follow-up cervical curvature index was detected in both groups (P > 0.05). Cervical range of motion was lower during final follow-up than pre-fixation in both groups (P < 0.01). Results confirmed that open-door laminoplasty with unilateral mass screw fixation and laminectomy with bilateral mass screw fixation have similar effectiveness in the improvement of neurological function, relieving pain and reducing complications, but will greatly reduce the cervical range of motion.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tissue Engineering, Cervical Spondylosis, Spinal Canal, Spine

CLC Number:

R318

Zhao Yong, Chu Yan-chen, Li Xue-sen, Ma Jin-long, Zou Yun-wen. Cervical posterior implant fixation for multi-segment cervical spondylotic myelopathy: improves symptoms but diminishes cervical range of motion[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(22): 3496-3502.

Figures/Tables 3

References

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中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程