الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cervical spondylosis is a progressive degenerative disease of the spine and a common spinal disorder all over the world. It is characterized by multi-segmental spinal cord compression, ossification of the posterior longitudinal ligament, and cervical stenotic myelopathy.
The main goals of surgical treatment in DCM are to decompress the spinal cord, maintain or restore cervical alignment and stabilize the involved segments when needed. To achieve these goals, many different surgical techniques were proposed. The choice of each one is based on patient characteristics (age, clinical symptoms, number of involved levels, site of compression, cervical alignment, previous surgeries, patients functional status, bone quality, presence of instability, among others), surgeon’s preference and analysis of risk and benefits of each approach over the other considering the case.
There are 2 main surgical approaches: the anterior approach and the posterior approach. Traditional anterior cervical decompression surgery includes anterior cervical discectomy or anterior corpectomy and fusion. Posterior cervical decompression surgery includes laminoplasty and laminectomy with or without fusion. The posterior cervical approach is a straight forward alternative to decompress the spinal cord and nerve roots with direct visualization.This approach is thought to be ideally suited for patients with multilevel CSM and patients with preservation of cervical lordosis.
The study included 38 patients randomly assigned into two groups, the first group (n=20) underwent multilevel cervical laminectomy while the second group (n=18) underwent multilevel cervical laminectomy with lateral mass fixation. The purpose of the study was to compare between mutltilevel cervical laminectomy,and multilevel cervical laminectomy with lateral mass fixation in patients with cervical spondylotic myelopathy regarding the functional clinical outcome and cervical spine normal sagittal alignment.
Patients were followed up for 12 months duration post-operative using functional modified Japanese orthopedic score (mJAO), andmeasurement of C2-C7 cobb`s angle to evaluate post-operative cervical sagittal alignment.
The results of this study revealed that there was a significant increase between pre- and post-operative modified Japanese orthopedic score among both groups. Regarding cervical sagittal alignment, no significant changes occurred after at least 12 months follow up period in the two groups.
Our findings postulate that both simple multilevel posterior cervical laminectomy and posterior cervical laminectomy with lateral mass fixation are associated with improvement in the functional outcome in CSM patients with preservation in normal cervical lordosis in at least 12 months follow up duration.
Recommendations included Longer follow up durations to evaluate the long-term effects of both approaches with inclusion of other posterior cervical approaches as Laminoplasty.
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