title: Cervical pedicle screw fixation combined with laminoplasty for cervical spondylotic myelopathy with instability.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  To evaluate the surgical results of cervical pedicle screw (CPS) fixation combined with laminoplasty for treating cervical spondylotic myelopathy (CSM) with instability.
  
  
  BACKGROUND
  Cervical fixation and spinal cord decompression are required for CSM patients with instability. However, only a few studies have reported on CPS fixation combined with posterior decompression for unstable CSM patients.
  
  
  METHODS
  Thirteen patients that underwent CPS fixation combined with laminoplasty for CSM with instability were evaluated in this study. We assessed the clinical and radiological results of the surgical procedures. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the clinical results. The percentages of sli p, difference in sli p angle between maximum flexion and maximum extension of unstable intervertebrae, and perforation rate of CPS were evaluated.
  
  
  RESULTS
  The mean JOA scores before surgery, immediately after surgery, and at final follow-up were 9.1, 13.3, and 12.6, respectively. The mean percentages of sli p before surgery, immediately after surgery, and at final follow-up were 9.1%, 3.2%, and 3.5%, respectively; there were significant improvements immediately after surgery and at final follow-up. The difference in sli p angle between the maximum flexion and maximum extension of the unstable intervertebrae changed from 9.0° before surgery to 1.6° at the final follow-up. The perforation rate of CPS was 10.9%.
  
  
  CONCLUSIONS
  The results suggest that CPS fixation combined with laminoplasty is an effective surgical procedure for treating CSM with instability.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Uehara
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Ogihara
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashidate
authors.forename: Keijiro
authors.initials: K
authors.lastname: Mukaiyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
keywords: Cervical fixation; Cervical spondylosis; Instability; Myelopathy