Clinical efficacy of laminectomy with instrumented fixation in treatment of adjacent segmental disease following ACCF surgery: a retrospective observational study of 48 patients

摘要

This study was designed to investigate the clinical efficacy of laminectomy with instrumented fixation in treatment of adjacent segmental diseases following anterior cervical corpectomy and fusion (ACCF) surgery. Between January 2008 and December 2015, 48 patients who underwent laminectomy with instrumented fixation to treat adjacent segmental diseases following ACCF surgery, were enrolled into this study. The patients were followed up at least 2 years. Pain assessment was determined by visual analogue scale (VAS) score and Neck Disability Index (NDI) score; neurological impairment was evaluated by Japanese Orthopaedic Association (JOA) score; and radiographic parameters were also compared. All comparisons were determined by paired t test with appropriate Bonferronni correction. VAS score preoperatively and at last follow-up was 5.28 ± 2.35 vs 1.90 ± 1.06 (P < 0.001). JOA score preoperatively and at last follow-up was 8.2 ± 3.6 vs 14.5 ± 1.1 (P < 0.001). NDI score preoperatively and at last follow-up was 30.5 ± 12.2 vs 10.6 ± 5.8 (P < 0.001). Moreover, the losses of cervical lordosis and C2-C7 range of motion after laminectomy were significant (both P < 0.005), but not sagittal vertical axis distance. Postoperative complications were few or mild. In conclusion, clinical effectiveness and safety can be guaranteed when the patients undergo laminectomy with instrumented fixation to treat adjacent segmental diseases following ACCF surgery.