Study of Functional Outcome of Cervical Laminoplasty with Fixation Versus Cervical Laminoplasty without Fixation for Multiple Levels for Degenerative Cervical Spondylotic Myelopathy with Modified Japanese Orthopedic Association Score

Abstract

Objective: To determine functional outcome of cervical laminoplasty with fixation versus without fixation for multiple levels of cervical spondylitis myelopathy. Cervical laminectomy is the standard operation for multiple cervical stenosis, which need decompressive surgery, however it is associated with significant number of recurrence and instability if it is not associated with posterior cervical fixation , usually the disease happens as a result go aging in old people mainly and most of the patients are old and fixation need times and expert, this makes the development of laminoplasty which lead to less instability which if it done in proper way it will not need fixation, in this study I review the outcome in patient have laminoplasty and fixation with patient who did not have associated fixation. Materials and Methods: 50 diagnosed cases of multiple level cervical myelopathy at king Abdulazaiz Hospital in Taif between 2012—2013 were retrospectively analyzed at, 1-year using MJOA. Results: 25 patients underwent 4 levels cervical laminoplasty with posterior lateral mass fixation compared to the same number of patients have 4 level cervical laminoplasty without fixation. The correlation between Duration of Symptoms to Preoperative and postoperative MJOA was statistically significant. We noted statistically significant improvement in symptoms of axial neck pain, radicular arm pain, and gait disturbances post operatively at one year in both groups. No difference between the group who had fixation with the group who did not regarding the improvement of symptoms and functional improvement. Conclusion: Functional outcomes in operated patients at 1-year follow up are the same after laminoplasty with or without fixation. But using fixation increases time of surgery. Symptoms of axial neck pain; radicular arm pain, clumsy hand and gait disturbances show significant improvement at one year follow up. While bladder and bowel involvement showed the least recovery. Significant improvement in function occurs 1 year postoperatively.