AI Article Synopsis
- The study aimed to assess the effectiveness of a specific surgical method, combining posterior cervical decompressive laminectomy, lateral mass screw fixation, and foraminotomy, for treating cervical radiculo-myelopathy in 58 patients.
- The surgeries were performed on patients with various cervical issues, and results showed significant improvement in both the Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score post-operation, indicating relief from symptoms.
- No major complications were reported, although some patients experienced minor issues like cervical pain; overall, the method appeared safe and effective over a follow-up period of approximately 3.4 years.
Article Abstract
Objective: To evaluate the effectiveness of posterior cervical decompressive laminectomy and lateral mass screw fixation combined with foraminotomy for treating cervical radiculo-myelopathy.
Methods: Between January 2010 and January 2012, 58 patients with cervical radiculo-myelopathy were treated by posterior cervical decompressive laminectomy and lateral mass screw fixation combined with foraminotomy. There were 31 males and 27 females, with an average age of 52.7 years (range, 41-72 years). The mean disease course was 5.4 years (range, 3-15 years). The preoperative Japanese Orthopaedic Association (JOA) score was 7.8±1.3, and visual analogue scale (VAS) score was 6.8±1.7. There were 37 cases of inter-vertebral disc herniation and ligamentum flavum hypertrophy, 11 cases of vertebral osteophyte formation with the osteophyte spinal canal occupational ratio of 51.7%±18.1%, and 10 cases of inter-vertebral disc herination with cervical instability. Preoperative cervical curvature was (-5.5±12.5)°. The fixed segments included C in 29 cases, C in 19 cases, and C in 10 cases. Foraminotomy was performed in 135 nerve foramina (mean, 2.33 foramina).
Results: The mean operation time was 204 minutes (range, 167-260 minutes), and the mean blood loss was 273 mL (range, 210-378 mL). No injury of vertebral artery or nerve root occurred during operation. Postoperative subcutaneous hematoma and cervical axial pain occurred in 1 case and 8 cases, respectively; and no nerve root palsy was observed. The patients were followed up 2.1-4.3 years (mean, 3.4 years). The postoperative JOA score was significantly increased to 14.1±1.7 (=-27.672, =0.000), with an improvement rate of 68.5%±21.9%. Postoperative VAS score was significantly decreased to 2.1±1.1 (=15.168, =0.000). The imaging examination showed adjacent segmental degeneration in 1 patient, who had no clinical symptom. There was no screw loosening or pseudoarthrosis formation during follow-up. The cervical curvature was (13.6±5.1)° at 5 days and was (13.2±4.8)° at 2 years, showing significant difference when compared with preoperative one (<0.05). The osteophyte spinal canal occupational ratio was 36.5%±10.4% at 2 years, showing significant difference when compared with preoperative one (=6.921, =0.000).
Conclusions: The procedure of posterior cervical decompressive laminectomy and lateral mass screw fixation combined with foraminotomy is effect in treating cervical radiculo-myelopathy. The spinal cord and nerve root can be adequately decompressed by laminectomy and foraminotomy. The lateral mass screw fixation can correct the cervical curvature and further reduce the tension to spinal cord.
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| http://dx.doi.org/10.7507/1002-1892.20160199 | DOI Listing |
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