BACKGROUND: Since Roy-Camille introduced lateral mass fixation in 1979, it has been widely used to fixate cervical spine after posterior cervical decompression.
this study is to evaluate safety and clinical outcome when using lateral mass screw fixation in sub-axial cervical spine combined with laminectomy in patients with multi-level cervical spondylotic myelopathy (CSM).
METHODS: A prospective clinical study where selected patients operated on for multi-level CSM from C3-C7 using laminectomy and lateral mass screw fixation with 6 months follow up. The patients showed either preoperative cervical instability, straight or kyphotic cervical curve and had preoperative cervical spine A-P, lateral, flexion and extension radiographs, CT scan and MRI and postoperative radiographs as preoperative views obtained at 1, 3 and 6 months after surgery CT scan was done within a week after surgery for screw trajectory and tip position. Myelopathy severity evaluated preoperative, 3-months and 6-months postoperative using Nurick myelopathy score. Functional status evaluated by Neck Disability Index (NDI) recorded preoperative, 3-months, and 6-months postoperative.
RESULTS: 25 patients included, aging from 52 to 68 years with a mean 58±7.8 years. 164 screws inserted. At the end of follow up good bone fusion and cervical stability in flexion and extension views achieved in all patients. There were significant improvements in both Nurick scores and NDI at 6-months post-operative compared to pre-operative scores (P |
