Abstract: ［Abstract］Objective〖HTSS〗〓To investigate the clinical significance of four different posterior operative ways on cervical curvature index(CCI) and axial symptom(AS) in the treatment of multilevel cervical spondylotic myelopathy(MCSM).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and thirtyfour patients with MCSM were randomly divided into four groups in this study. 34 patients underwent traditional laminectomy， 35 patients underwent opendoor laminectomy， 33 patients underwent lateral mass screw fixation， 32 patients underwent cervical pedicle screw fixation. All the patients were examined with Xray, CT and MRI. The operation time, bleeding volume, postoperative drainage volume, recovery time, nerve function before and after operation, CCI and AS were compared in 4 groups.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓There was no significant difference in operation time, bleeding volume, postoperative drainage volume and recovery time among 4 groups(P＞005) . There was no difference in Japanese Orthopaedic Association score recovery rate among 4 groups(P＞005). The CCI loss rate of opendoor laminectomy group, lateral mass screw group and pedicle screw group were less than that of traditional laminectomy group, the CCI loss rate of lateral mass screw group and pedicle screw group was less than that of opendoor laminectomy group(P＜005) . The intervertebral height of lateral mass screw group and pedicle screw group was lost less than that of traditional laminectomy group and opendoor laminectomy group(P＜005), There was no significant difference between the 4 groups in the axial symptoms and the distribution of AS(P＞005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Lateral mass screw and cervical pedicle screw fixation made a good clinical outcome. Although there was no significant effect on the postoperative recovery rate, the stability of cervical spine was significantly increased. They can effectively prevent postoperative curvature loss and reduce the occurrence of serious AS.

Key words: cervical spondylosis, laminectomy, treatment outcome