Abstract:

Objective: The purpose of this study was to evaluate clinical and radiological findings related to the treatment of the patients with cervical spondylotic myelopathy (CSMP) in our medical center who underwent posterior cervical laminectomy and posterolateral fusion surgery with lateral mass screw fixation (LMSF). Materials and Methods: In this study, the postoperative clinical and radiological results of 30 patients who underwent posterior laminectomy and posterolateral fusion surgery by a single spinal surgeon with the diagnosis of cervical spondylosis in our medical center between 2015 and 2019 were retrospectively evaluated. Results: In total, 30 patients [23 males (76.7%) and 7 females (23.3%)] were included in the study, and the follow-up period was 6 to 44 months with an average of 21.2 months. In total, 91 laminectomies were performed on the cervical vertebrae of our patients. The mean diameter of the spinal canal in the narrowest place was 5.80 mm (9.6, 2.5) in the preoperative period, and 11.16 mm (13.6-9.4) in the postoperative period. In the postoperative period, an average of 1.35 mm (0.4-3.1) spinal cord shift was observed. The mean modified Japanese Orthopedic Association scores of all patients increased postoperatively to 15.2 (8-18) from the preoperative values of 12 (6-16). While mean preoperative Cobb angle in Group A was - 23.5º (-45º/-10º), mean postoperative Cobb angle was -9.8º (-34º/+15º). While mean preoperative Cobb angle in Group B was +13.8º (+3º/+33º), mean postoperative Cobb angle was +13.3º (+32º/-5º). Conclusion: In the treatment of patients with CSMP, adequate spinal canal decompression is created with posterior laminectomy and the LMSF technique, and these provide sufficient neurological recovery and stability. Posterolateral stabilization can preserve cervical alignment in patients with lordotic spine alignment and prevent progressive kyphosis after laminectomy; however, if anterior osteophytosis is present in patients with a preoperative loss of lordosis or kyphotic alignment, this technique may not be suitable for ideal lordotic alignment.

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