Treatments Of Cervical Spinal Stenosis: Comparative Study Of Two Posterior Operative Methods

Objective: It has been reported that cervical open-door laminoplasty can cause degree of cervical curve straightened or even kyphotic malformation to a certain extent. In addition, it can also leave long term axial symptoms. However, combining screw-rod fixation system can effectively stop cervical vertebae from instability along with prevent degree of cervical curve from straightening. In this study, the focus is to compare the clinical effectiveness of the two different therapy for treating degenerative cervical spinal stenosis.Methods:To review all 87 patients with degenerative cervical spinal stenosis who have had the operation. To separate those patients into two groups based on the type of operation i.e. Group A (non-fixation 40 patients) and Group B (fixation 47 patients). To analyze statistically using the identical clinical outcome & image measurement evaluation standard before and after the operation on the patient as well as following up.Results:RIS after surgery for Group A (non-fixation) is 53.2±19.81% and for Group B (fixation) is 61.16±15.08% , at the follow-up point JOA score for Group A is 12.41±4.21, and for Group B is 12.36±3.77(P=0.326>0.05). Incidence rate of axial symptoms for Group A is 37.5% and for Group B is 27.7% (P=0.015<0.05). Incidence rate of kyphotic malformation for Group A is 40% and for Group B is 12.8%(P=0.006<0.05). The reduced amount of ROM for Group A averaged at 6.8±10.5 and for Group B averaged at 8.2±11.3(P>0.05).Conclusion: The incidence rate of axial symptoms reduced as a result of combining open-door laminoplasty & lateral mass screw-rod fixation system in contrast with only open-door laminoplasty. Even to certain degree there was some loss on ROM of the patient after lateral mass screw-rod fixation, however, it gives a great sense of powerful support to the cervical vertebrae after the surgery which lowered the rate of cervical vertebrae instability from happening, hence benefiting the patient in the long run with regards to the living quality.