Relationship of Change in Cervical Curvature after Laminectomy with Lateral Mass Screw Fixation to Spinal Cord Shift and Clinical Efficacy

Shu-bing Hou; Xian-ze Sun; Feng-yu Liu; Rui Gong; Zheng-qi Zhao; Kuan Lu; Yan-bing Liu

doi:10.1055/s-0041-1723807

Journal of Neurological Surgery Part A: Central European Neurosurgery, Table of Contents

J Neurol Surg A Cent Eur Neurosurg 2022; 83(02): 129-134
DOI: 10.1055/s-0041-1723807

Original Article

Relationship of Change in Cervical Curvature after Laminectomy with Lateral Mass Screw Fixation to Spinal Cord Shift and Clinical Efficacy

Authors

Shu-bing Hou

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Xian-ze Sun

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Feng-yu Liu

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Rui Gong

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Zheng-qi Zhao

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Kuan Lu

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China
Yan-bing Liu

¹Department of Spine Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, China

Abstract

Background and Study Aims Although laminectomy with lateral mass screw fixation (LCSF) is an effective surgical treatment for cervical spondylotic myelopathy (CSM), loss of cervical curvature may result. This study aimed to investigate the effect of cervical curvature on spinal cord drift distance and clinical efficacy.

Patients and Methods We retrospectively analyzed 78 consecutive CSM patients with normal cervical curvature who underwent LCSF. Cervical curvature was measured according to Borden's method 6 months after surgery. Study patients were divided into two groups: group A, reduced cervical curvature (cervical lordosis depth 0–7mm; n = 42); and group B, normal cervical curvature (cervical lordosis depth 7–17mm; n = 36). Spinal cord drift distance, laminectomy width, neurologic functional recovery, axial symptom (AS) severity, and incidence of C5 palsy were measured and compared.

Results Cervical lordosis depth was 5.1 ± 1.2 mm in group A and 12.3 ± 2.4 mm in group B (p < 0.05). Laminectomy width was 21.5 ± 2.6 mm in group A and 21.9 ± 2.8 mm in group B (p > 0.05). Spinal cord drift distance was significantly shorter in group A (1.9 ± 0.4 vs. 2.6 ± 0.7 mm; p < 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased after surgery in both groups (p < 0.05). Neurologic recovery rate did not differ between the two groups (61.5 vs. 62.7%; p > 0.05). AS severity was significantly higher in group A (p < 0.05). C5 palsy occurred in three group A patients (7.1%) and four group B patients (11.1%), but the difference was not significant (p > 0.05).

Conclusion After LCSF, 53.8% of the patients developed loss of cervical curvature. A smaller cervical curvature resulted in a shorter spinal cord drift distance. Loss of cervical curvature was related to AS severity but not improvement of neurologic function or incidence of C5 palsy.

Keywords

laminectomy - cervical spondylotic myelopathy - cervical curvature - axial symptoms - C5 palsy

Full Text

References

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