Open-door laminoplasty with lateral mass screw fusion in the treatment of multisegmental cervical spondylotic myelopathy with segmental instability

Abstract

Objective To investigate the effectiveness of open-door laminoplasty with lateral mass screw fusion in the treatment of multisegmental cervical spondylotic myelopathy(CSM)with segmental instability. Methods Forty-one patients with multisegmental cervical spondylotic myelopathy combined with instability underwent open-door laminoplasty with lateral mass screw fusion.The JOA(Japanese Orthopaedic Association)scoring system and Neck Disability Index(NDI)were applied to evaluate neurological function and axial neck/shoulder pain before and after surgery, respectively.In addition, the Ishihara method was used to measure the cervical curvature index(CCI), and spinal cord expansion was calculated with MRI. Results After 43 months of postoperative follow-up, there were significant differences in JOA scores[(7.12±0.91) vs.(14.73±1.12), t=35.28, P 0.05]. Conclusions Open-door laminoplasty with lateral mass screw fusion can improve neurological function and maintain the normal cervical curvature.Therefore, it is effective in the treatment of multisegmental cervical spondylotic myelopathy with segmental instability. Key words: Cervical spondylotic myelopathy; Segmental instability; Laminoplasty; Lateral mass screw