COMPARISON OF TWO POSTERIOR INSTRUMENTATION TECHNIQUES IN MULTILEVEL CERVICAL SPONDYLOTIC MYELOPATHY TREATMENT: LATERAL MASS SCREW FIXATION VS PEDICLE SCREW FIXATION

Özet

Objective: In this study we compared the clinical results of two posterior instrumentation methods in surgical treatment of multilevel cervical spondylotic myelopathy (CSM) and we aimed to share the clinical outcomes. Materials and Methods: This study was a retrospective analysis of patients with multilevel CSM disease who underwent decompression and posterior internal fixation with lateral mass screw (LMS) or pedicle screw (PS). The study included 63 patients and the patients were divided into two groups. The LMS group comprised 32 patients and the PS group included 31 patients. C2-7 cervical lordosis, modified Japanese Orthopedic Association (mJOA) scores, neck disability index (NDI) and visual analog scale (VAS) assessments of the groups were compared. Complications were noted and analyzed in detail. Results: In the PS group, change in C2-7 lordosis was found to be significantly higher than the LMS group (p<0.001). Changes in quality of life indices (mJOA, NDI and VAS) in the postoperative period did not show a significant difference between LMS and PS groups (p=0.608, p=0.224 and p=0.296). In the study group, 10 complications were observed in 63 patients (10/63, 15.8%). Implant related complication ratio was found to be significantly higher in the LMS group. Conclusion: Both of the posterior instrumentation methods revealed similar results in terms of quality of life indices. In this study, better results were obtained in the PS group in terms of C2-7 lordosis and implant-related complications. We think that both methods can be used in CSM treatment, however PS fixation is technically challenging with a long learning curve. Therefore, we have the opinion that it can be applied in selected patients by trained and experienced surgeons.