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ORIGINAL ARTICLE
Year : 2020  |  Volume : 33  |  Issue : 4  |  Page : 1393-1398

Comparative study of posterior cervical laminectomy vs facet fixation without laminectomy for the treatment of cervical spondylotic myelopathy


Department of Neurosurgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Ahmed F Elmahdy
Department of Neurosurgery, Faculty of Medicine, Menoufia University, Menoufia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_86_20

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Objective The aim was to compare facet fixation operation as the sole management of cervical spondylotic myelopathy (CSM) vs posterior cervical laminectomy without facet fixation. Background CSM is a chronic spinal cord dysfunction in the cervical region due to cervical spondylosis, which is an age-related degenerative disorder of the cervical spine components. It is caused by a combination of static and dynamic degenerative factors in the adult population of more than 50 years. Surgical decompression of the spinal canal is the primary treatment of choice, which can be done directly by eliminating the static factors as in posterior cervical laminectomy or indirectly by eliminating the dynamic factors as in facet fixation leading to regression of the spondylotic process. Patients and methods This comparative prospective study involved 40 patients with CSM, who were randomly distributed into two equal groups. The patients were followed up for 6 months. Results Among the 40 patients, two groups were described. Group 1 included 20 patients who underwent posterior cervical laminectomy without fixation. Group 2 included 20 patients who underwent facet fixation without laminectomy. Postoperative neurological recovery rate at the end of the follow-up period was satisfactory (excellent and good) in 55% in group 1 and 70% in group 2. Conclusion Both facet fixation and posterior cervical laminectomy techniques are simple, safe, and effective procedures in achieving relief and improvement in patients with multilevel CSM. Facet fixation provided better postoperative Nurick's grades, Modified Japanese Orthopedic Association scores, and better postoperative neurological recovery rate (NRR) without significant complications while postoperative instability and kyphosis remains the main drawback of posterior cervical laminectomy.


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