Laminectomy alone versus laminectomy with lateral mass screw fixation in the treatment of multisegment cervical spinal canal stenosis: a comparative analysis

Abstract

Multisegment cervical canal stenosis is one of the most common causes of spinal cord dysfunction. Cervical laminectomy affords direct relief from dorsal stenosis, but many concerns were raised regarding its effect on spinal stability and cervical sagittal alignment. Laminectomy in conjunction with lateral mass screws is aiming to prevent recurrence of stenosis and to achieve much improvement of the cervical spine range of motion and curvature. To compare the clinical and radiological outcome of laminectomy alone versus laminectomy with lateral mass screw fixation in the treatment of patients with multisegment cervical canal stenosis. A retrospective study conducted on 46 patients with multisegment cervical canal stenosis who were treated between April 2018 and April 2021. Patients were divided into two groups. The 20 cases in group (A) underwent conventional laminectomies and the 26 cases in group (B) underwent laminectomies with lateral mass screw fixation. Operative complications, visual analogue scale (VAS), neurological functional recovery and cervical curvature changes were compared between the two groups. Operative times in group A were significantly less than it was in group B (P < 0.001). The postoperative VAS scores in group B were significantly lower than those in group A (P < 0.05). No statistical differences in the modified Japanese Orthopedic Association score could be found between the two groups after surgery. Patients in group B in comparison with those in group A had good alignment of the cervical spine with maintenance of curvature index (P < 0.001). In multilevel cervical canal stenosis, internal fixation using lateral mass screws in conjunction with laminectomy can be of a considerable significance than laminectomy alone in improving the axial symptoms and ceasing further disease progression through stabilization of the cervical spine and maintaining the sagittal alignment.