The clinical outcome of lateral mass fixation after decompressive laminectomy in cervical spondylotic myelopathy

Abstract

Lateral mass cervical fixation is the technique of choice for posterior cervical stabilization of the lower cervical spine in the cases of cervical spondylotic myelopathy. It is used for patients who had extensive, multiple-level laminectomies with reversed cervical lordosis.
Objective: The aim of this study was to evaluate the outcome of decompressive laminectomy of cervical spondylotic myelopathy with lateral mass fixation compared with decompressive laminectomy only without fixation.
Patients and methods: The study was conducted on 32 patients operated for cervical decompressive laminectomy with lateral mass fixation using polyaxial screws and rods at different levels of the subaxial cervical spine named group I, compared with 30 patients operated for cervical decompressive laminectomy only without lateral mass fixation named group II.
Results: Group I comprised 22 males (68.8%) and 10 females (31.2%), the age ranged from 36 to 63 years. Group II comprised 18 males (60%) and 12 females (40%), the age ranged from 40 to 66 years with a mean of 51± 7.73. In group I, the mean operative time was 110 ±14.16 min, the mean hospital stay was 4± 1.76 days and the mean blood loss was 480 ± 193.04 ml. In group II, the mean operative time was 75± 24.38 min, the mean hospital stay was 3±1.57 days, and the mean blood loss was 220 ± 111.22 ml. There was a clinically significant difference as regards neck pain and brachialgia. In group I, neck pain improved in 68.8% and brachialgia improved in 83.3% but in group II, neck pain improved in 46.7% and brachialgia improved in 61.5%. Myelopathy and sphincteric disturbance showed clinical improvement but without clinically significant difference of both groups.
Conclusions: Lateral mass fixation of the cervical spine after cervical laminectomy is safe and reliable with few complications. It also improves neck pain and brachialgia.