An Assessment of the Effectiveness of Surgical Treatment Methods Used for Cervical Spondylosis.

Abstract

To evaluate the preoperative and postoperative clinical and radiological findings of patients treated surgically for cervical spondylosis. The patients included in the study (n=32) were divided into three groups according to their preferred surgical approach. These surgical approaches are posterior cervical laminectomy, posterior cervical laminectomy plus fusion, and anterior approach. Then, pre-and postoperative modified Japanese Orthopaedic Association Myelopathy (mJOA) scores, Torg- Pavlov ratios measured on direct cervical radiography, and pre-and postoperative lordosis angles were recorded. The data obtained were evaluated statistically. The radiological examinations revealed that the average preoperative Torg-Pavlov ratio was < 1 in 29 patients. The average sagittal spinal canal diameter was 9 mm, and myelomalacia was detected in 25 patients. Postoperative mJOA scores in patients who underwent anterior corpectomy and fusion and posterior laminectomy were statistically significant (p < 0.05). The highest symptomatic recovery rate was found in patients with preoperative neck pain. This finding was not statistically significant (p > 0.05). Changes in the postoperative lordosis angles and recovery rates were also observed, depending on the preferred surgical approach. If there is no kyphotic deformity or straightening of the cervical lordosis, a posterior laminectomy can be performed to avoid the long-term complications caused by an anterior corpectomy. It should be kept in mind that multi-segment and wide laminectomies may cause instability problems.