The effect of surgical immobilization after laminectomy in the treatment of advanced cases of cervical spondylotic myelopathy.

Surgical immobilization of the cervical spine after laminectomy is proposed for the treatment of severe cervical spondylotic myelopathy (CSM) occurring with diffuse stenosis of the spinal canal (congenital or acquired). In 20 consecutive patients showing advanced CSM and cord compression at various levels, a laminectomy with posterior fixation was made, in most cases with the aid of a metal plate. In the evaluation of the severity of the myelopathy a slight modification of the Nurick scale was used. With the exception of three patients who developed complications unrelated to the technique, the results were very good as demonstrated by the long lasting improvement in the performance of the patients. The results emphasize the role which mechanical factors may play both, in the genesis of the disease and in the failures of the plain laminectomy.