Changes in cervical sagittal parameters and the impact on axial symptoms after two types of posterior single-door cervical decompression surgeries.

OBJECTIVE

The present study aimed to assess the impact of two posterior single-door cervical decompression procedures on axial symptoms and cervical sagittal parameters in patients with cervical spondylosis.

METHODS

A retrospective study was performed on the clinical records of 185 patients diagnosed with cervical spondylosis who had surgical interventions from January 2021 to January 2023. The patients were categorized into two groups: a study group that underwent laminoplasty combined with C3 laminectomy, and a control group that received the standard C3-7 single-door laminoplasty procedure. The groups were compared based on postoperative Japanese Orthopaedic Association (JOA) scores, incidence of axial symptoms, and cervical parameters such as range of motion (ROM), cervical curvature index (CCI), and C2-7 Cobb angle.

RESULTS

No notable differences were observed in JOA scores and the rates of neurological function recovery between the groups. The occurrence of axial symptoms was markedly reduced in the study group when compared to the control group, with rates of 22.50 % and 61.54 %, respectively.(P < 0.05). Postoperatively, a significant reduction in CCI was observed in both groups (P < 0.05). However, the study group showed a markedly more substantial improvement in CCI than the control group, with the difference reaching statistical significance (P < 0.05). Additionally, the study group showed significantly less loss of ROM and cervical curvature than the control group post-surgery (P < 0.05).

CONCLUSION

Compared to conventional single door laminoplasty, laminoplasty with C3 laminectomy more effectively decompresses nerves in patients with cervical spondylosis while preserving the structural and functional integrity of the cervical spine and minimizing postoperative axial symptoms. This surgical approach is crucial for maintaining cervical sagittal balance and functional integrity.