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Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy
BACKGROUND: The role of laminectomy alone as an etiology of postoperative cervical instability is well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417305/ https://www.ncbi.nlm.nih.gov/pubmed/30937025 http://dx.doi.org/10.4103/ajns.AJNS_303_17 |
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author | Hamdan, Ali Rabee Kamel Mahmoud, Radwan Nouby Al Mamoun, Momen Mohammed El Khateeb, Eslam El Sayed |
author_facet | Hamdan, Ali Rabee Kamel Mahmoud, Radwan Nouby Al Mamoun, Momen Mohammed El Khateeb, Eslam El Sayed |
author_sort | Hamdan, Ali Rabee Kamel |
collection | PubMed |
description | BACKGROUND: The role of laminectomy alone as an etiology of postoperative cervical instability is well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment effectiveness has recently gained attention. OBJECTIVE: This is a prospective observational study aims to observe the possible relation between cervical sagittal alignment and functional outcomes following sub-axial cervical lateral mass screw fixation in patients with cervical spondylotic myelopathy. PATIENTS AND METHODS: Thirty patients were included in this study all suffering from cervical spondylotic mylopathy (CSM) who underwent cervical laminectomy and screw-rod fixation and followed up over 6 months. Functional outcome accessed using Nurick myelopathy score and neck disability index (NDI)?. We also used the Cobb angle method (C(2)–C(7)) as a parameter for radiographic assessment of the cervical sagittal alignment which was measured preoperatively and postoperatively on lateral neutral views of cervical X-ray. RESULTS: All the patients underwent cervical laminectomy and fixation in a range of 3–5 levels. Two intraoperative facet fractures and four facet joint violations were observed. All the patients were followed-up for at least 6 months. There were significant improvements of the motor power (88.5%), Nurick score (90%), and NDI (90%) postoperatively. The mean preoperative Cobb angle for all patients was −8.51° ± 14.07° standard deviation (SD) which changed to −10.29 ± 12.43 SD at the end of follow-up. CONCLUSION: Combing posterior decompression with lateral mass screw– rod in patients with CSM was effective in improving or at least maintaining cervical alignment with the good functional outcome. |
format | Online Article Text |
id | pubmed-6417305 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-64173052019-04-01 Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy Hamdan, Ali Rabee Kamel Mahmoud, Radwan Nouby Al Mamoun, Momen Mohammed El Khateeb, Eslam El Sayed Asian J Neurosurg Original Article BACKGROUND: The role of laminectomy alone as an etiology of postoperative cervical instability is well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment effectiveness has recently gained attention. OBJECTIVE: This is a prospective observational study aims to observe the possible relation between cervical sagittal alignment and functional outcomes following sub-axial cervical lateral mass screw fixation in patients with cervical spondylotic myelopathy. PATIENTS AND METHODS: Thirty patients were included in this study all suffering from cervical spondylotic mylopathy (CSM) who underwent cervical laminectomy and screw-rod fixation and followed up over 6 months. Functional outcome accessed using Nurick myelopathy score and neck disability index (NDI)?. We also used the Cobb angle method (C(2)–C(7)) as a parameter for radiographic assessment of the cervical sagittal alignment which was measured preoperatively and postoperatively on lateral neutral views of cervical X-ray. RESULTS: All the patients underwent cervical laminectomy and fixation in a range of 3–5 levels. Two intraoperative facet fractures and four facet joint violations were observed. All the patients were followed-up for at least 6 months. There were significant improvements of the motor power (88.5%), Nurick score (90%), and NDI (90%) postoperatively. The mean preoperative Cobb angle for all patients was −8.51° ± 14.07° standard deviation (SD) which changed to −10.29 ± 12.43 SD at the end of follow-up. CONCLUSION: Combing posterior decompression with lateral mass screw– rod in patients with CSM was effective in improving or at least maintaining cervical alignment with the good functional outcome. Medknow Publications & Media Pvt Ltd 2019 /pmc/articles/PMC6417305/ /pubmed/30937025 http://dx.doi.org/10.4103/ajns.AJNS_303_17 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Hamdan, Ali Rabee Kamel Mahmoud, Radwan Nouby Al Mamoun, Momen Mohammed El Khateeb, Eslam El Sayed Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title | Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title_full | Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title_fullStr | Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title_full_unstemmed | Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title_short | Effect of Sub-axial Cervical Lateral Mass Screw Fixation on Functional Outcome in Patients with Cervical Spondylotic Myelopathy |
title_sort | effect of sub-axial cervical lateral mass screw fixation on functional outcome in patients with cervical spondylotic myelopathy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417305/ https://www.ncbi.nlm.nih.gov/pubmed/30937025 http://dx.doi.org/10.4103/ajns.AJNS_303_17 |
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