Abstract:

Objective: The comparison of patients who underwent different surgical procedures for cervical spinal stenosis in clinical and radiological terms with various factors. Materials and Methods: Sixty-two patients (52 males, 10 females) were divided into groups as corpectomy (group 1), laminectomy (group 2) and laminoplasty (group 3). The patients were evaluated retrospectively considering their neurological examinations, Japanese Orthopaedic Association scores and radiological findings pre and postoperatively Results: The mean recovery rate was 63.2±3.7%. The pre-op/post-op JOA scores of the patients were found to be 15.7±1.6/16.1±1.6 in group 1, 13.9±3.4/13.3±3.42 in group 2 and, and 14.1±3.7/15.4±3.0 in group 3. In terms of JOA scores the increase of the pre-op and post-op changes only in group 3 was found to be statistically significant. Statistically significant results were obtained in group 1 in terms of post-op JOA scores of the patients under the age of 60; whose sagittal cord diameter was measured as 6 mm or less in the pre-op cervical computed tomography (CT), with lordotic alignment of the pre-op cervical axis and who did not have T2 signal intensity increase in the pre-op magnetic resonance imaging (MRI). While evaluating group 2, no statistically significant results were obtained in any of the parameters. In group 3, it was seen that the factors including male gender, age below 60 years, sagittal cord diameter being 6 mm or less in pre-op cervical CT measurement, lordotic alignment of the pre-op cervical axis and no increase in T2 signal intensity in pre-op cervical MRI were seen to be statistically significant indicators for the result. Conclusion: Early results show that better outcomes can be obtained when anterior corpectomy and fusion and open-door laminoplasty is performed in patients with under the age of 60, have pre-op a sagittal cord diameter of 6 mm or less and lordotic alignment and no myelomalacia on MRI. It has been observed that better clinical and radiologic recovery can be expected in selected patients.

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