Ten-year clinical and radiographic results of computer-assisted cervical pedicle screw fixation combined with laminoplasty

Abstract

Objective: Cervical pedicle screw (CPS) fixation is widely used for the treatment of cervical spinal instability from various causes; however, there are few reports on the long-term outcomes of this procedure. The present study evaluated the 10-year results of CPS fixation for cervical instability. Methods: The medical records of 13 consecutive patients who underwent computer-guided CPS fixation for cervical instability were reviewed. The mean observation period was 153 months. Evaluated items included Japanese Orthopaedic Association (JOA) score and C2-7 lordotic angle before surgery and at 5 and 10 years afterwards. Visual analog scale (VAS) scores for neck pain and radiological evidence of adjacent segment degeneration (ASD) at 10 years of follow-up were also assessed. Results: Mean JOA score significantly improved from 9.4 points before surgery to 13.2 points at 5 years after surgery (p < 0.001), followed next by a slight reduction to 11.6 points at 10 years postoperatively. C2-7 lordotic angle tended to decrease from 7.9° preoperatively to 5.3° at 10 years after surgery. No clinically significant complications, such as neurovascular injury caused by screw misplacement, were observed. The mean VAS score for neck pain was 31.7 points at the study endpoint, and ASD rate was 23.1%. Conclusions: At 10 years after CPS fixation, mean JOA score was improved without symptoms indicative of cervical myelopathy recurrence. Our long-term results confirm that computer-assisted CPS fixation is useful for treating cervical instability.

Keywords

• Cervical pedicle screw
• Cervical instability
• Long-term results
• Adjacent segment degeneration
• Neck pain