Abstract
Background: The role of laminectomy alone as an etiology of postoperative cervical instability is
well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional
outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment
effectiveness has recently gained attention. Study Design: This is a prospective, observational,
surgical cohort suffering from cervical spondylotic myelopathy (CSM). Objective: This study
aims to observe the possible relation between cervical sagittal alignment and patient functional
outcomes following subaxial cervical lateral mass screw fi xation in patients with cervical spondylotic
myelopathy. Patients and Methods: Thirty patients were included in this study all suffering from
CSM who underwent cervical laminectomy and screw-rod fi xation and followed up over 6 months.
Functional outcome accessed using Nurick myelopathy score and neck disability index (NDI)?. We
also used the Cobb angle method (C2–C7) as a parameter for radiographic assessment of the cervical
sagittal alignment which was measured preoperatively and postoperatively on lateral neutral views of
cervical X-ray. Results: All 30 patients underwent cervical laminectomy and fi xation in a range of
3–5 levels. Two intraoperative facet fractures and four facet joint violations were observed. All the
patients were followed-up for at least 6 months. There were signifi cant improvement of the motor
power (88.5%), Nurick score (90%), and NDI (90%) postoperatively. The mean preoperative Cobb
angle for all patients was −8.51° ± 14.07° standard deviation (SD) which changed to −10.29 ± 12.43
SD at the end of follow-up. Conclusion: Combing posterior decompression with lateral mass
screw– rod in patients with CSM was effective in improving or at least maintaining cervical
alignment with the good functional outcome.