title: Preserving the C7 spinous process in laminectomy combined with lateral mass screw to prevent axial symptom.
abstract: BACKGROUND
  Preserving the C7 spinous process during cervical laminoplasty has been reported to prevent axial symptom. Some patients underwent laminectomy and fixation developed the symptom. The objective of this article was to investigate whether axial symptom can be reduced by preserving the C7 spinous process during cervical laminectomy and fixation with lateral mass screw.
  
  
  METHODS
  Between 2005 and 2008, data of 53 patients who underwent laminectomy and lateral mass-screw fixation for multilevel cervical myelopathy were reviewed. Analysis consisted of the incidence of axial symptom, Japan Orthopaedic Association (JOA) scores, recovery rate, cervical lordotic angle, and atrophy rate of cervical posterior muscle. Axial symptom severity was quantified by a visual analog scale (VAS). Twenty-five patients were decompressed from C3 to C7 (group A) and 28 from C3 to C6 with dome-shape removal of the C7 superior lamina (group B).
  
  
  RESULTS
  Analysis of final follow-up data showed improvement in clinical outcome for both groups. No difference in recovery rate, cervical lordotic angle and atrophy rate was observed between groups. Postoperative axial-neck pain was significantly rarer in group B than in group A. Axial symptom severity was correlated with cervical posterior muscle atrophy rate; correlation coefficient was 0.665.
  
  
  CONCLUSIONS
  The C7 spinous process might play an important role in preventing axial symptom, but there is a need for randomized, control studies with long-term follow-up to clarify the results.
authors: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, China.
authors: Peng
authors: P
authors: Zhang
authors: Yong
authors: Y
authors: Shen
authors: Ying-Ze
authors: YZ
authors: Zhang
authors: Wen-Yuan
authors: WY
authors: Ding
authors: Jia-Xin
authors: JX
authors: Xu
authors: Jun-Ming
authors: JM
authors: Cao
mesh_terms: D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D012189:Retrospective Studies; D013115:Spinal Canal / Q000601:surgery; D013118:Spinal Cord Diseases / Q000601:surgery*