Abstract:

BACKGROUND: Axial symptoms often occur in patients after posterior cervical single-door vertebroplasty. Some studies have proposed a modified surgical method to remove C₃ lamina and retain cervical semisacinous muscle on C₂ spinous to reduce the occurrence of axial symptoms after surgery.

OBJECTIVE: To compare the clinical effects, cervical motion range and curvature of C₃ laminectomy and mini-titanium plate fixation after single-door vertebroplasty.

METHODS: Totally 43 patients with cervical spondylosis were selected from the General Hospital of Southern Theater Command of PLA from June 2012 to June 2017, including 25 males and 18 females. Among them, 27 patients underwent C_3-6 or C_3-7 single-door mini-titanium fixation vertebroplasty as fixation group and 16 patients underwent C_4-6 or C_4-7 single-door mini-titanium fixation vertebroplasty through posterior approach after C₃ laminectomy as resection group. Preoperatively, 6 months postoperatively and at final follow-up, JOA score, cervical motion range, and C_2-7 Cobb angle were compared between the two groups. This study was approved by the Ethics Committee of General Hospital of Southern Theater Command of PLA.

RESULTS AND CONCLUSION: (1) All 43 patients successfully underwent the operation without vascular or spinal cord injury. (2) JOA score was higher in the two groups at postoperative 6 months and final follow-up than that preoperatively (P < 0.05). There was no significant difference in JOA scores between the two groups before and after surgery (P > 0.05). (3) Motion range in the two groups was smaller at postoperative 6 months and final follow-up than that preoperatively (P < 0.05). Motion range was smaller in the fixation group than in the resection group at postoperative 6 months and final follow-up (P < 0.05). (4) C_2-7 Cobb angle in the two groups was smaller at postoperative 6 months and final follow-up than that preoperatively (P < 0.05). C_2-7 Cobb angle was smaller in the fixation group than in the resection group at postoperative 6 months and final follow-up (P < 0.05). (5) There was no hypersensitivity, rejection or immune response in the two groups. (6) Results indicate that C₃ laminectomy and mini-titanium plate fixation have the same effect on improving neurological function, but the removal of C₃ lamina can more effectively prevent the reduction of postoperative cervical motion range and curvature.

Key words: mini-titanium plate, posterior cervical approach, single-door, laminectomy, laminoplasty, internal fixation, axial symptoms, cervical motion range, cervical curvature