Abstract
Kurokawa’s procedure is associated with a satisfactory clinical outcome. However, excessive loss of cervical lordosis often occurred. A total of 31 patients were treated with Kurokawa’s procedure until February 2005. From March 2005 another 28 patients were operated using our technique which consisted in preservation of posterior elements. Our procedure enables us to preserve the C2 insertion of semispinalis cervics and, re-attachment of spinous process and extensor musculature from C3 to C7. Patients were clinically evaluated using the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy and postoperative axial pain. Radiologic evaluation of cervical alignment and cervical range of motion (the difference between lordotic angle at maximum extension and at maximum flexion) performed pre and postoperatively. The mean follow-up period was 36 and 8 months, respectively for Kurokawa’s and our procedure. Although, there were not significant differences between Kurokawa’s and our procedure when comparing the recovery rate through the JOA score, the decreasing rate of cervical range of motion, and the rate of postoperative axial pain. However, the average postoperative lordotic angle increased 1.8 degrees in our procedure while in Kurokawa’s procedure it decreased 4.1 degrees, respectively. Preservation of the C2 insertion of semispinalis cervics as dynamic stabilizer and posterior ligamentous complex as static stabilizer in our procedure, lead to an effective cervical alignment.
