Sagittal Balance Correction in Cervical Compressive Myelopathy: Is it Helpful?

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Laminectomy with lateral mass and transfacet fixation are standard for cervical compressive myelopathy (CCM).
• Optimizing fixation techniques is crucial for improving surgical outcomes in CCM patients.

Purpose of the Study:

• To evaluate the efficacy of multilevel fixation including the C7-T1 transfacet junction for CCM.
• To compare surgical outcomes between standard lateral mass fixation and fixation incorporating the C7-T1 transfacet junction.

Main Methods:

• A study of 102 CCM patients undergoing cervical laminectomy.
• Group A: Lateral mass fixation only. Group B: Lateral mass fixation plus C7-T1 transfacet junction fixation.
• Comparison of neurological outcomes and sagittal balance (T1 slope) at 3 months and 2 years post-surgery.

Main Results:

• Group B showed a shorter hospital stay and improved motor function in upper and lower limbs at 3 months.
• Group B patients exhibited better neurological outcomes (MJOS scores) and reduced T1 slope at both 3 months and 2 years.
• No significant differences in presenting complaints or postoperative complications were observed between groups.

Conclusions:

• Cervical laminectomy with posterior fixation, including C7-T1 transfacet junction fixation, significantly improves neurological outcomes in CCM.
• Normalizing sagittal balance via this enhanced fixation technique leads to better short- and long-term results for CCM patients.