Efficacy of Posterior Cervical Laminectomy and Decompression plus Lateral Mass Screw-Rod Internal Fixation in the Treatment of Multisegment Cervical Spinal Canal Stenosis and Effects on Cervical Curvature and Range of Motion Parameters.

Bo Liu,Yufei Wang,Yaning Zhang,Songwen Tan

doi:10.1155/2021/6001877

Abstract

Objective To investigate the clinical effects of posterior laminectomy and decompression plus lateral mass screw-rod internal fixation for the treatment of multisegment cervical spinal canal stenosis and the improvement of cervical curvature and range of motion in patients. Methods A total of 68 patients with multisegment cervical spinal stenosis who were treated in our hospital from January 2019 to June 2020 were selected and randomly divided into the control group and the observation group according to the random number table, with 34 patients in each group. The patients in the control group were treated with traditional posterior cervical open-door laminoplasty with silk suture fixation, while those in the observation group were treated with posterior cervical laminectomy and decompression plus lateral mass screw-rod internal fixation. The perioperative index of patients in the two groups was recorded, and the clinical efficacy of patients was evaluated. The patient's JOA score, cervical physiological curvature, and cervical range of motion were evaluated. The occurrence of complications was recorded during follow-up. Results The amount of intraoperative bleeding and postoperative rehabilitation training time in the observation group was less than that in the control group (P < 0.05). There was no significant difference in operation time between the two groups (P > 0.05). The total effective rate of the observation group was significantly higher than that of the control group (P < 0.05). The JOA scores at 1 week, 6 months, and 12 months after operation in the observation group were higher than those in the control group (P < 0.05). The physiological curvature of cervical spine in the observation group at 1 week, 6 months, and 12 months after operation was higher than that in the control group (P < 0.05). The cervical range of motion at 12 months after operation in the observation group was significantly higher than that in the control group (P < 0.05). The incidence of postoperative complications in patients of the observation group was significantly lower than that of the control group (P < 0.05). Conclusion Posterior laminectomy and decompression plus lateral mass screw-rod internal fixation can help patients to improve various clinical symptoms caused by nerve compression and obtain better improvement of cervical curvature and range of motion. It is an ideal surgical method for the treatment of multisegment cervical spinal canal stenosis, and it is conducive to improving the clinical efficacy of patients.

Highlights

Cervical spondylotic myelopathy is a common and frequently occurring disease in orthopedics clinics, and cervical spinal stenosis is one of the important pathological bases of cervical spondylotic myelopathy [1, 2]
Posterior cervical laminectomy and decompression plus lateral mass screw-rod internal fixation have a wide range of indications, which are mainly used in (1) those in the stage of spinal cord compression ≥3; (2) the ossification of the longitudinal ligament behind cervical vertebra suffers from spinal cord compression, which is difficult to be decompressed through anterior approach surgery; (3) the compression of cervical spinal cord comes from the calcification or hypertrophy of yellow ligament at the rear; (4) patients still having symptoms of spinal cord compression after anterior surgery; (5) patients who had anterior-posterior compression of the cervical spinal cord and the absolute value of the anterior-posterior diameter of spinal canal
We compared the therapeutic effects of traditional posterior cervical open-door laminoplasty with silk suture fixation and posterior cervical laminectomy plus lateral mass screw-rod internal fixation, in order to provide reference for the clinical treatment of patients with multisegment cervical spinal canal stenosis

Summary

Objective

To investigate the clinical effects of posterior laminectomy and decompression plus lateral mass screw-rod internal fixation for the treatment of multisegment cervical spinal canal stenosis and the improvement of cervical curvature and range of motion in patients. Posterior laminectomy and decompression plus lateral mass screw-rod internal fixation can help patients to improve various clinical symptoms caused by nerve compression and obtain better improvement of cervical curvature and range of motion. It is an ideal surgical method for the treatment of multisegment cervical spinal canal stenosis, and it is conducive to improving the clinical efficacy of patients

Introduction

Data and Methods

Results