Posterior dynamic/semi-rigid stabilization as an effective treatment for cervical spinal stenosis

Abstract

AIM: To investigate the short- term results of dynamic/semi-rigid stabilization in patients with cervical spinal stenosis and compare them with patients for which decompression and pos-terior cervical fusion was performed. MATERIAL and METHODS: 28 patients were included in this study. Group 1 was the semi-rigid group (four male, ten female), group 2 was the fusion group (nine male, five female). We compared the clinical status of the patients pre-operatively, first and twelfth month post-operatively using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Also radiologically, the pre-operative and on the postoperative first and twelfth month, cervical sagittal vertical axis (cSVA), cervical lordosis (C0–2) (C2–7) and T1 slope were measured. RESULTS: Our results showed that there was a significant improvement on the VAS and NDI score after semi-rigid and fusion surgery (p<0.001). Also the cervical lordosis was obtained in both groups (p=0.033). Although, no significant differences was found between both groups regarding the change of variables over time between post-operative first and twelfth month. CONCLUSION: Although, posterior dynamic stabilization has been previously used in thoracic and lumbar pathologies before, there is no crucial evidence about their effects in cervical stenosis. This study states, that semi-rigid instrumentation is as effective in clinical and radiologic out-comes as posterior fusion surgery in periods of one year. Also, the lower risk of adjacent-segment disease and pseudoarthrosis and preservation of cervical sagittal alignment are the main advantages of the new method.