An Assessment of the Effectiveness of Surgical Treatment Methods Used for Cervical Spondylosis

Turk Neurosurg. 2022;32(2):261-270. doi: 10.5137/1019-5149.JTN.33981-21.2.

Abstract

Aim: To evaluate the preoperative and postoperative clinical and radiological findings of patients treated surgically for cervical spondylosis.

Material and methods: The patients included in the study (n=32) were divided into three groups according to their preferred surgical approach. These surgical approaches are posterior cervical laminectomy, posterior cervical laminectomy plus fusion, and anterior approach. Then, pre-and postoperative modified Japanese Orthopaedic Association Myelopathy (mJOA) scores, Torg- Pavlov ratios measured on direct cervical radiography, and pre-and postoperative lordosis angles were recorded. The data obtained were evaluated statistically.

Results: The radiological examinations revealed that the average preoperative Torg-Pavlov ratio was < 1 in 29 patients. The average sagittal spinal canal diameter was 9 mm, and myelomalacia was detected in 25 patients. Postoperative mJOA scores in patients who underwent anterior corpectomy and fusion and posterior laminectomy were statistically significant (p < 0.05). The highest symptomatic recovery rate was found in patients with preoperative neck pain. This finding was not statistically significant (p > 0.05). Changes in the postoperative lordosis angles and recovery rates were also observed, depending on the preferred surgical approach.

Conclusion: If there is no kyphotic deformity or straightening of the cervical lordosis, a posterior laminectomy can be performed to avoid the long-term complications caused by an anterior corpectomy. It should be kept in mind that multi-segment and wide laminectomies may cause instability problems.

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Decompression, Surgical / methods
  • Humans
  • Laminectomy / adverse effects
  • Retrospective Studies
  • Spinal Fusion* / methods
  • Spondylosis* / complications
  • Spondylosis* / diagnostic imaging
  • Spondylosis* / surgery
  • Treatment Outcome