scholarly journals Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chao-Jui Chang ◽  
Wei-Ren Su ◽  
Kai-Lan Hsu ◽  
Chih-Kai Hong ◽  
Fa-Chuan Kuan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Biomechanical Study ◽  
Fixation Strength ◽  
Myotendinous Junction ◽  
Steel Cable ◽  
Simple Modification ◽  
Greater Tuberosity ◽  
Cerclage Wire ◽  
Group A ◽  
Group B

Abstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures. Materials and methods Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured. Results The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01), Conclusions The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures. Trial registration Retrospectively registered.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

A comparative study of laminoplasty with short segment transpedicular screw fixation versus laminoplasty with anterior fusion in treating extensional cervical spinal cord injury without radio graphic abnormality in adults

2019 ◽  
Author(s):  
Bi Zhang ◽  
Zhenhai Zhou ◽  
Honggui Yu ◽  
Zhimin Pan ◽  
Rongping Zhou ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Intraoperative Blood Loss ◽  
Short Segment ◽  
Transpedicular Screw ◽  
Cord Injury ◽  
Group A ◽  
Group B ◽  
Transpedicular Screw Fixation

Abstract Background: Cervical spinal cord injury(CSCI) without major fracture or dislocation is often described as cervical SCI without radiographic abnormality (SCIWORA). Majority of this injury could be without radiographic abnormality but with disrupted anterior longitudinal ligament or intervertebral disc unless examined by MRI. The optimal surgical management of this cervical spinal cord injury remains controversial. This study is to evaluate the clinical advantages of laminoplasty combined with short-segment transpedicular screw fixation for managing this issue. Methods: SCIWORA patients were collected into two groups according to different surgical methods. Patients in group A received laminoplasty combined with transpedicular screw fixation, and patients in group B received anterior cervical fusion combined with laminoplasty. All cervical spine were assessed by X-ray, CT, MRI preoperatively and postoperatively to evaluate the decompression range, bonegraft fusion and instruments location. ASIA grade and JOA score were recorded to assess the neurological function recovery. Complications, surgery time, intraoperative blood loss and hospital stay were compared between two groups. Mean follow-up was at least 2 years. Results: In this study, Forty eight patients were in group A and 54 ones were in group B. All cases were decompressed fully and obtained fusion 6-month postoperatively. The ASIA grade was improved postoperatively, but no significantly different between two groups (p=0.907). The JOA was 6.12±1.76 preoperatively and improved to 11.98±2.98 postoperatively with the 53.13% neurofunction recovery rate in group A, with no significantly different compared with group B(vs 6.63±2.45, p=0.235; vs 12.62±3.59, p=0.303; vs 57.76%, p=0.590)respectively. Total 18 complications occurred but the occurrence was significant lower in group A(p=0.020). The average surgery time was 2.2±0.32 hours, intraoperative blood loss was 304±56ml and hospital stay was 8.2±3.1 days, significantly decreased compared with group B(vs 3.1±0.29, p=0.000; vs 388±61ml, p=0.000; vs 12±2.8days, p=0.000)respectively. Conclusions: Cervical laminoplasty combined with short-segment transpedicular screw fixation is a reliable option to treat SCIWORA patients with CSS. The advantages include achieving sufficient cervical decompression, maintaining cervical stability and avoiding extra anterior cervical fusion which increases surgery time, intraoperative blood loss, postoperative complications and hospital stay.

Comparison of Three Different Screw Trajectories in Osteoporotic Vertebrae: A Biomechanical Investigation

2020 ◽  
Author(s):  
Jan-Sven Jarvers ◽  
Stefan Schleifenbaum ◽  
Christian Pfeifle ◽  
Christoph Oefner ◽  
Melanie Edel ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Fatigue Behavior ◽  
Fixation Strength ◽  
Patient Specific ◽  
Promising Alternative ◽  
Cortical Bone Trajectory ◽  
Pull Out ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background: Pedicle screw insertion in osteoporotic patients is challenging. Achieving more screw-cortical bone purchase and invasiveness minimization, the cortical bone trajectory and the midline cortical techniques represent alternatives to traditional pedicle screws. This study compares the fatigue behavior and fixation strength of the cement-augmented traditional trajectory (TT), the cortical bone trajectory (CBT) and the midline cortical (MC). Methods: Ten human cadaveric spine specimens (L1 - L5) were examined. The average age was 86.3 ± 7.2 years. CT scans were provided for preoperative planning. CBT and MC were implanted by using the patient-specific 3D-printed placement guide (MySpine®, Medacta International), TT were implanted freehand. All 10 cadaveric specimens were randomized to group A (CBT vs. MC) or group B (MC vs. TT). Each screw was loaded for 10,000 cycles. The failure criterion was doubling of the initial screw displacement resulting from the compressive force (60 N) at the first cycle, the stop criterion as a doubling of the initial screw displacement. After dynamic testing, screws were pulled out axially at 5 mm/min to determine their remaining fixation strength. Results: The mean pull-out forces did not differ significantly. Concerning the fatigue performance, only one out of ten MC of group A failed prematurely due to loosening after 1,500 cycles (L3). Five CBT already loosened during the first 500 cycles. The mean displacement was always lower in the MC. In group B, all TT showed no signs of failure or loosening. Three MC failed already after 26 cycles, 1,510 cycles, and 2,144 cycles, respectively. The TT showed always a lower mean displacement. In the subsequent pull-out tests, the remaining mean fixation strength of the MC (449.6 ± 298.9 N) was slightly higher compared to the mean pull-out force of the CBT (401.2 ± 261.4 N). However, MC (714.5 ± 488.0 N) were inferior to TT (990.2 ± 451.9 N).Conclusion: The current study demonstrated that cement-augmented TT have best fatigue and pull-out characteristics in osteoporotic lumbar vertebrae, followed by the MC and CBT. MC represent a promising alternative in osteoporotic bone if cement augmentation should be avoided. Using the patient-specific guide contributes to improve screws’ biomechanical properties.

scholarly journals Is cement-augmented sacroiliac screw fixation with partially threaded screws superior to that with fully threaded screws concerning compression and pull-out force in fragility fractures of the sacrum? – a biomechanical analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juliana Hack ◽  
Maiwand Safi ◽  
Martin Bäumlein ◽  
Julia Lenz ◽  
Christopher Bliemel ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Fragility Fractures ◽  
Cement Augmentation ◽  
Osteoporotic Bone ◽  
Sacroiliac Screw ◽  
Pull Out ◽  
Sacroiliac Screw Fixation ◽  
Group A ◽  
Group B ◽  
Screw Group

Abstract Background Providing a stable osteosynthesis in fragility fractures of the pelvis can be challenging. Cement augmentation increases screw fixation in osteoporotic bone. Generating interfragmentary compression by using a lag screw also improves the stability. However, it is not known if interfragmentary compression can be achieved in osteoporotic sacral bone by cement augmentation of lag screws. The purpose of this study was to compare cement-augmented sacroiliac screw osteosynthesis using partially versus fully threaded screws in osteoporotic hemipelvises concerning compression of fracture gap and pull-out force. Methods Nine fresh-frozen human cadaveric pelvises with osteoporosis were used. In all specimens, one side was treated with an augmented fully threaded screw (group A), and the other side with an augmented partially threaded screw (group B) after generating a vertical osteotomy on both sides of each sacrum. Afterwards, first a compression test with fracture gap measurement after tightening of the screws was performed, followed by an axial pull-out test measuring the maximum pull-out force of the screws. Results The fracture gap was significantly wider in group A (mean: 1.90 mm; SD: 1.64) than in group B (mean: 0.91 mm; SD: 1.03; p = 0.028). Pull-out force was higher in group A (mean: 1696 N; SD: 1452) than in group B (mean: 1616 N; SD: 824), but this difference was not statistically significant (p = 0.767). Conclusions Cement augmentation of partially threaded screws in sacroiliac screw fixation allows narrowing of the fracture gap even in osteoporotic bone, while resistance against pull-out force is not significantly lower in partially threaded screws compared to fully threaded screws.

scholarly journals A new biomechanical classification system for split fractures of the humeral greater tuberosity: guidelines for surgical treatment

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gang Liu ◽  
Xiaoguang Guo ◽  
Qian Zhao ◽  
Bo Qin ◽  
Junjie Lu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Classification System ◽  
Fixation Method ◽  
Medium Size ◽  
Greater Tuberosity ◽  
Load To Failure ◽  
Group A ◽  
Single Fragment ◽  
Group B ◽  
Group D

Abstract Background Split fractures of the humeral greater tuberosity (HGT) are common injuries. Although there are numerous surgical treatments for these fractures, no classification system combining clinical and biomechanical characteristics has been presented to guide the choice of fixation method. Methods We created a standardised fracture of the HGT in 24 formalin-fixed cadavers. Six were left as single-fragment fractures (Group A), six were further prepared to create single-fragment with medium size full-thickness rotator cuff tear (FT-RCT) fractures (Group B), six were cut to create multi-fragment fractures (Group C), and six were cut to create multi-fragment with FT-RCT fractures (Group D). Each specimen was fixed with a shortened proximal humeral internal locking system (PHILOS) plate. The fixed fractures were subjected to load and load-to-failure tests and the differences between groups analysed. Results The mean load-to-failure values were significantly different between groups (Group A, 446.83 ± 38.98 N; Group B, 384.17 ± 36.15 N; Group C, 317.17 ± 23.32 N and Group D, 266.83 ± 37.65 N, P < 0.05). The load-to-failure values for fractures with a greater tuberosity displacement of 10 mm were significantly different between each group (Group A, 194.00 ± 29.23 N; Group B, 157.00 ± 29.97 N; Group C, 109.00 ± 17.64 N and Group D, 79.67.83 ± 15.50 N; P < 0.05). These findings indicate that fractures with a displacement of 10 mm have different characteristics and should be considered separately from other HGT fractures when deciding surgical treatment. Conclusions Biomechanical classification of split fractures of the HGT is a reliable method of categorising these fractures in order to decide surgical treatment. Our findings and proposed system will be a useful to guide the choice of surgical technique for the treatment of fractures of the HGT.

scholarly journals Application of 3-Dimensional Printing Guide Template and Pointed Lotus-Style Regulator in Percutaneous Pedicle Screw Fixation for Thoracolumbar Fractures

2021 ◽  
Author(s):  
Ming Zhang ◽  
Jiayi Li ◽  
Tao Fang ◽  
Jing Yan ◽  
Lungang Wu ◽  
...  
Keyword(s):  
3D Printing ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
3 Dimensional ◽  
Percutaneous Pedicle Screw ◽  
Group A ◽  
Group B ◽  
Percutaneous Pedicle Screw Fixation ◽  
First Time

Abstract This study aims to analysis the efficacy of the 3D printing percutaneous guide template in combination with the pointed lotus-style regulator in percutaneous pedicle screw fixation.60thoracolumbar fractures patients receiving percutaneous pedicle screw fixation (PPSF) were enrolled and randomly divided into 3 groups. Patients in Group A received traditional PPSF, while patients in Group B received PPSF with flat end lotus-style regulator and patients in Group C received PPSF with pointed lotus-style regulator. The experimental results showed that the highest number of pedicle screw successfully inserted by the first time was in group C, while lowest in group A (P<0.05). The total time of fluoroscopy and operation were lower in group C, and higher in group A (P<0.05). VAS and ODI scores were all lower after surgery than before surgery in 3groups. VAS and ODI scores were lower in group B and C, compared with group A at day 1 ,7 after surgery (P<0.05). KA decreased significantly in 3 groups after surgery and no difference in KA change between 3 groups (P>0.05). Taken together, Application of the 3D printing guide template in combination with pointed lotus-style regulator improved the accuracy of pedicle insertion.Trial registration: ClinicalTrials.gov Identifier: NCT04980131. Registered 18/07/2021.

scholarly journals Comparison of the clinical efficacy of two fixation methods combined with OLIF in the treatment of lumbar spondylolisthesis

2021 ◽  
Author(s):  
Xinliang Zhang ◽  
Yunshan Guo ◽  
Yibing Li
Keyword(s):  
Clinical Efficacy ◽  
Screw Fixation ◽  
Fusion Rate ◽  
Imaging Data ◽  
Fixation Methods ◽  
Post Surgery ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Lumbar Spondylolisthesis

Abstract Background To observe the clinical efficacy of an anterior single rob-screw fixation (ASRSF) combined with the oblique lumbar intervertebral fusion (OLIF) approach compared with a posterior percutaneous screw fixation(PPSF) combined with OLIF in the treatment of lumbar spondylolisthesis. Methods This is a retrospective case-control study. Patients with lumbar spondylolisthesis treated with either ASRSF combined with OLIF or PPSF combined with OLIF from January 2016 to January 2018 were enrolled in this study. None of the patients had posterior decompression. The visual analog scale (VAS) and Oswestry dysfunction index (ODI) were used for clinical efficacy assessment. The pre- and post-operational disc height, height of foramen, subsidence and migration of cages, fusion rate, and surgery-related complications were compared between the two groups. Results Fifty-three patients were included in this single-center study. According to the fixation methods, patients were divided into the ASRSF group (group A, 25 cases) and the PPSF group (group B, 28 cases). There was no statistical difference in surgery-related complications between groups. There was a significant difference in the VAS score at 1 week post-surgery(2.3 ± 0.5Vs3.5 ± 0.4, P = 0.01), and 3 months post-operation (2.2 ± 0.3VS 3.0 ± 0.3, P = 0.01). Comparison of post-operative imaging data showed that there was a significant difference in the height of the foramen between groups at 3 months post-surgery(18.1 ± 2.3 mm Vs 16.9 ± 1.9 mm, P = 0.04). At 24 months post-surgery, the ODI was 12.65 ± 3.6 in group A and 19.1 ± 3.4 in group B (P = 0.01). Twelve months after surgery, the fusion rate in group A was 72.0% and78.6% in group B (not statistically significant, P = 0.75). Fusions were identified in all patients at 24 months post-surgery. Conclusion Compared to PPSF, ASRSF combined with OLIF for lumbar spondylolisthesis can reduce post-operative low back pain in the early stages, maintain the height of the foramen superiorly, and improve the performance of lumbar function.

A New Biomechanical Classification System for Split Fractures of the Humeral Greater Tuberosity: Guidelines for Surgical Treatment

2021 ◽  
Author(s):  
Gang Liu ◽  
Xiaoguang Guo ◽  
Qian Zhao ◽  
Bo Qin ◽  
Junjie Lu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Classification System ◽  
Fixation Method ◽  
Medium Size ◽  
Greater Tuberosity ◽  
Load To Failure ◽  
Group A ◽  
Single Fragment ◽  
Group B ◽  
Group D

Abstract Background: Split fractures of the humeral greater tuberosity (HGT) are common injuries. Although there are numerous surgical treatments for these fractures, no classification system combining clinical and biomechanical characteristics has been presented to guide the choice of fixation method.Methods: We created a standardised fracture of the HGT in 24 formalin-fixed cadavers. Six were left as single-fragment fractures (Group A), six were further prepared to create single-fragment with medium size full-thickness rotator cuff tear (FT-RCTs) fractures (Group B), six were cut to create multi-fragment fractures (Group C), and six were cut to create multi-fragment with FT-RCT fractures (Group D). Each specimen was fixed with a shortened proximal humeral internal locking system (PHILOS) plate. The fixed fractures were subjected to load and load-to-failure tests and the differences between groups analysed.Results: The mean load-to-failure values were significantly different between groups (Group A, 446.83 ± 38.98 N; Group B, 384.17 ± 36.15 N; Group C, 317.17 ± 23.32 N and Group D, 266.83 ± 37.65 N, P < 0.05). The load-to-failure values for fractures with a greater tuberosity displacement of 10 mm were significantly different between each group (Group A, 194.00 ± 29.23 N; Group B, 157.00 ± 29.97 N; Group C, 109.00 ± 17.64 N and Group D, 79.67.83 ± 15.50 N; P < 0.05). These findings indicates that fractures with a displacement of 10 mm have different characteristics and should be considered separately from other HGT fractures when deciding surgical treatment.Conclusions: Biomechanical classification of split fractures of the HGT is a reliable method of categorising these fractures in order to decide surgical treatment. Our findings and proposed system will be a useful to guide the choice of surgical technique for the treatment of fractures of the HGT.

scholarly journals Latarjet with cortical button fixation is associated with an increase of the risk of recurrent dislocation compared to screw fixation

2019 ◽  
Vol 28 (7) ◽  
pp. 2354-2360 ◽  
Author(s):  
Alexandre Hardy ◽  
◽  
Vincent Sabatier ◽  
Bradley Schoch ◽  
Marie Vigan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Cohort Analysis ◽  
Recurrent Dislocation ◽  
Latarjet Procedure ◽  
Fixation Group ◽  
Increased Risk ◽  
Cortical Button ◽  
Group A ◽  
Group B

Abstract Purpose The purpose of this study was to compare the clinical results of the Latarjet procedure using two cortical buttons vs two screws. It was hypothesized that cortical button would result in similar rates of recurrent dislocations, but a lower rate of reoperation compared to screw fixation. Methods A retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior glenohumeral instability. Patient demographics, number of dislocations prior surgery, arm dominance, shoulder hyperlaxity, level of sport, type of sport and ISIS score were collected. Shoulders were separated into two groups based on surgical fixation (screws vs cortical button). Postoperatively, shoulders were evaluated for recurrent dislocation, revision surgery, post-operative Walch–Duplay score, and the Simple shoulder test (SST). Two hundred and thirty-six patients were included in the screw fixation group (group A) and 72 in button fixation group (group B) and were evaluated at a mean follow-up of 3.4 ± 0.8 years. Demographics of the two groups were similar with the exception of operative side hand dominance, which was more common in group B [50 (69.4%) vs 128 (54.2%), p = 0.02]. Results Recurrent dislocation was significantly lower in Group A: 6 (2.5%) vs 6(8.3%) (p = 0.02). Reoperation was more common in group A [14 (5.9%) vs 0 (0%)]. At follow-up, Walch–Duplay scores and simple shoulder tests were similar in both groups. Conclusion Button fixation for Latarjet showed higher rates of recurrent dislocation compared to screw fixation. However, the increased stability afforded by screw fixation needs to be weighed against the increased risk of reoperation for hardware prominence. Level of evidence III.

scholarly journals Cervical curvature changes following laminectomy with lateral mass screw fixation: Does it relate with spinal cord shift and clinical efficacy

2020 ◽  
Author(s):  
Shu-bing Hou ◽  
Xian-ze Sun ◽  
Feng-yu Liu ◽  
Rui Gong ◽  
Zheng-qi Zhao ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Efficacy ◽  
Screw Fixation ◽  
Lateral Mass ◽  
Cervical Lordosis ◽  
Lateral Mass Screw ◽  
C5 Palsy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background Laminectomy with lateral mass screw fixation (LCSF) is an effective operation type for the treatment of cervical spondylotic myelopathy (CSM), however, the cervical curvature loss is often observed in some patients after operation. Will the cervical curvature change affect the spinal cord drift distance and the decompression effect? The aim of this study is to investigate the effects of different cervical curvature on spinal cord drift distance and clinical efficacy. Methods A total of 78 cases of CSM patients underwent LCSF were included in this retrospective study. The cervical curvature was measured according to the Bordon method 6 months after the operation, and the patients were divided into two groups. Group A: 42 cases with reduced cervical curvature (0 < the cervical lordosis depth < 7 mm) and group B: 36 cases with normal cervical curvature (7 mm ≤ the cervical lordosis depth ≤ 17 mm). The spinal cord drift distance, laminectomy width, neurological functional recovery, axial symptom (AS) severity and the occurrence of C5 palsy in both groups were observed. Results The cervical lordosis depth was (5.1 ± 1.2) mm in group A and (12.3 ± 2.4) mm in group B (P < 0.05). The laminectomy width was (21.5 ± 2.6) mm in group A and (21.9 ± 2.8) mm in group B (P > 0.05). The spinal cord drift distance was (1.9 ± 0.4) mm in group A and (2.6 ± 0.7) mm in group B, with statistically significant difference between the two groups (P < 0.05). The postoperative JOA scores in both groups were significantly increased (P < 0.05), and there was no significant difference in the neurological recovery rate (61.5% vs 62.7%) between the two groups (P > 0.05). According to the grading standard of AS, the severity of AS in group A was significantly higher than that in group B (P < 0.05). Three cases (7.1%) of C5 palsy occurred in group A and 4 cases (11.1%) occurred in group B (P > 0.05). Conclusion After LCSF, more than half of the patients had cervical curvature loss. The smaller of the cervical curvature was, the shorter distance the spinal cord drifted backward. The loss of cervical curvature was related to the severity of axial symptoms, rather than the improvement of neurological function and C5 palsy.

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