Posterior laminectomy and fusion

Abstract Background: This study aimed to predict the C5 palsy (C5P) after posterior laminectomy and fusion (PLF) with cervical myelopathy (CM) from routinely available variables by using support vector machine (SVM) method.Methods: We conducted a retrospective investigation based on 184 consecutive patients with CM after PLF, and data was collected from March 2013 to December 2019. Clinical and imaging variables were obtained and imported into univariable and multivariable logistics regression analysis to identify risk factors for C5P. According to published reports and clinical experience, a series of variables was selected to develop an SVM machine learning model to predict C5P. The accuracy (ACC), area under the receiver operating characteristic curve (AUC) and confusion matrices were used to evaluate the performance of the prediction model.Results: Among the total 184 consecutive patients, C5P occurred in 26 patients (14.13%). Multivariate analyses demonstrated the following 4 independent factors associated with C5P: electromyogram abnormal (odds ratio [OR] = 7.861), JOA recovery rate (OR = 1.412), modified Pavlov ratio (OR = 0.009), and presence of foraminal stenosis C4-C5 (OR = 15.492). The SVM model achieved an area under receiver operating characteristic curve (AUC) of 0.923 and ACC of 0.918. Meanwhile, the confusion matrix shown the classification results of the discriminant analysis. Conclusions: The designed SVM model presented a satisfied performance in predicting C5P from routinely available variables. However, future external validation is needed.

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Prediction of the risk of C5 palsy after posterior laminectomy and fusion with cervical myelopathy using a support vector machine: an analysis of 184 consecutive patients

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02476-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Haosheng Wang ◽

Zhi-Ri Tang ◽

Wenle Li ◽

Tingting Fan ◽

Jianwu Zhao ◽

...

Keyword(s):

Support Vector Machine ◽

Receiver Operating Characteristic Curve ◽

Cervical Myelopathy ◽

Operating Characteristic ◽

Characteristic Curve ◽

Support Vector ◽

Svm Model ◽

Operating Characteristic Curve ◽

Posterior Laminectomy ◽

Laminectomy And Fusion

Abstract Background This study aimed to predict C5 palsy (C5P) after posterior laminectomy and fusion (PLF) with cervical myelopathy (CM) from routinely available variables using a support vector machine (SVM) method. Methods We conducted a retrospective investigation based on 184 consecutive patients with CM after PLF, and data were collected from March 2013 to December 2019. Clinical and imaging variables were obtained and imported into univariable and multivariable logistic regression analyses to identify risk factors for C5P. According to published reports and clinical experience, a series of variables was selected to develop an SVM machine learning model to predict C5P. The accuracy (ACC), area under the receiver operating characteristic curve (AUC), and confusion matrices were used to evaluate the performance of the prediction model. Results Among the 184 consecutive patients, C5P occurred in 26 patients (14.13%). Multivariate analyses demonstrated the following 4 independent factors associated with C5P: abnormal electromyogram (odds ratio [OR] = 7.861), JOA recovery rate (OR = 1.412), modified Pavlov ratio (OR = 0.009), and presence of C4–C5 foraminal stenosis (OR = 15.492). The SVM model achieved an area under the receiver operating characteristic curve (AUC) of 0.923 and an ACC of 0.918. Additionally, the confusion matrix showed the classification results of the discriminant analysis. Conclusions The designed SVM model presented satisfactory performance in predicting C5P from routinely available variables. However, future external validation is needed.

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Does Cervical Sagittal Alignment Correlate with Outcomes following Posterior Laminectomy and Fusion for Cervical Myelopathy?

The Spine Journal ◽

10.1016/j.spinee.2015.07.149 ◽

2015 ◽

Vol 15 (10) ◽

pp. S144

Author(s):

John A. Sielatycki ◽

Sheyan J. Armaghani ◽

Arnold Silverberg ◽

Matthew J. McGirt ◽

Clinton J. Devin ◽

...

Keyword(s):

Cervical Myelopathy ◽

Sagittal Alignment ◽

Cervical Sagittal Alignment ◽

Posterior Laminectomy ◽

Laminectomy And Fusion

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6 Posterior Laminectomy and Fusion

Pocket Atlas of Spine Surgery ◽

10.1055/b-0038-161754 ◽

2018 ◽

Keyword(s):

Posterior Laminectomy ◽

Laminectomy And Fusion

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Anterior cervical discectomy and fusion with stand-alone anchored cages versus posterior laminectomy and fusion for four-level cervical spondylotic myelopathy: a retrospective study with 2-year follow-up

BMC Musculoskeletal Disorders ◽

10.1186/s12891-018-2136-1 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 8

Author(s):

Bing Wang ◽

Guohua Lü ◽

Lei Kuang

Keyword(s):

Retrospective Study ◽

Cervical Spondylotic Myelopathy ◽

Anterior Cervical Discectomy ◽

Cervical Discectomy ◽

Posterior Laminectomy ◽

Laminectomy And Fusion

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Perioperative Complications of Surgery for Degenerative Cervical Myelopathy: A Comparison Between 3 Procedures

Global Spine Journal ◽

10.1177/2192568221998306 ◽

2021 ◽

pp. 219256822199830

Author(s):

Mohamed Kamal Mesregah ◽

Blake Formanek ◽

John C. Liu ◽

Zorica Buser ◽

Jeffrey C. Wang

Keyword(s):

Propensity Score ◽

Cervical Myelopathy ◽

Perioperative Complications ◽

International Classification Of Diseases ◽

Significance Level ◽

Chi Squared ◽

Retrospective Comparative Study ◽

Posterior Laminectomy ◽

Degenerative Cervical Myelopathy ◽

New Onset

Study Design: Retrospective comparative study. Objectives: To compare the perioperative complications of propensity score-matched cohorts of patients with degenerative cervical myelopathy (DCM), who were treated with anterior cervical discectomy and fusion (ACDF), posterior laminectomy with fusion, or laminoplasty. Methods: The Humana PearlDiver Patient Record Database was queried using the International Classification of Diseases (ICD-9 and ICD-10) and the Current Procedural Terminology (CPT) codes. Propensity score-matched analysis was done using multiple Chi-squared tests with Bonferroni correction of the significance level. Results: Cohorts of 11,790 patients who had ACDF, 2,257 patients who had posterior laminectomy with fusion, and 477 patients who had laminoplasty, were identified. After propensity score matching, all the 3 groups included 464 patients. The incidence of dysphagia increased significantly following ACDF compared to laminoplasty, P < 0.001, and in laminectomy with fusion compared to laminoplasty, P < 0.001. The incidence of new-onset cervicalgia was higher in ACDF compared to laminoplasty, P = 0.005, and in laminectomy with fusion compared to laminoplasty, P = 0.004. The incidence of limb paralysis increased significantly in laminectomy with fusion compared to ACDF, P = 0.002. The revision rate at 1 year increased significantly in laminectomy with fusion compared to laminoplasty, P < 0.001, and in ACDF compared to laminoplasty, P < 0.001. Conclusions: The incidence of dysphagia following laminectomy with fusion was not different compared to ACDF. Postoperative new-onset cervicalgia and revisions were least common in laminoplasty. The highest rate of postoperative limb paralysis was noticed in laminectomy with fusion.

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Role of Femoral Ring Allograft in Anterior Interbody Fusion of the Spine

Journal of Orthopaedic Surgery ◽

10.1177/230949900100900202 ◽

2001 ◽

Vol 9 (2) ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Areesak Chotivichit ◽

Takuya Fujita ◽

Tze-Hong Wong ◽

John P Kostuik ◽

Ann N Sieber

Keyword(s):

Interbody Fusion ◽

Radiolucent Line ◽

Degenerative Change ◽

Congenital Scoliosis ◽

Anterior Fusion ◽

Anterior Interbody Fusion ◽

Femoral Ring ◽

Grade Ii ◽

Posterior Laminectomy

A review was carried out on 59 patients (10 males and 49 females) who had anterior interbody fusion performed with femoral ring allograft packed with autograft bone chips with a minimum follow up of 2 years. The average age at the time of surgery was 49.1 year old (26 to 75). The total number of levels grafted was 141. The diagnosis consisted of multiple degenerative disease in 6, degenerative change below the long segment of fusion for scoliosis in 9, osteoporosis with collapsed fracture in 3, pseudarthrosis after posterior laminectomy and fusion in 35, congenital scoliosis in 3, scoliosis in 2 and paralytic scoliosis due to multiple sclerosis in one. The distribution of levels fused was T12-L1 in 6, L1–2 in 12, L2–3 in 17, L3–4 in 22, L4–5 in 35 and L5-S1 in 39. The remaining 10 levels were in the lower thoracic areas (T7-T12). The operations were performed as anterior fusion alone in 13 patients, one-stage anterior and posterior fusion in 26 patients and two-stage surgery in 20 patients. Anterior instrumentation was used in all 141 levels. At average follow-up (33.7 months) there was no significant change in allograft angles (average = 1.6o). Fusion of the allograft was classified by Bridwell's grading system. At 24 months of the follow up, 97 % of the allografts were in grade I (fully incorporated) and 3% were in grade II (partially incorporated). Compared to 12 months follow-up only 76.2% of the grafts were in grade I, 28 % were in grade II and 0.8% were in grade III. Two patients had deep posterior infections which required further surgery (without resorption of the allograft anteriorly). One patient had a screw migration anteriorly which required removal. Three patients had persistence of radiolucent line at one of the vertebral end plates – graft interfaces but no subsidence of the graft or pain. In conclusion, the femoral ring allograft appeared to benefit the anterior interbody fusion in complex spinal surgery.

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Benign osteoblastoma of a thoracic vertebra

Journal of Neurosurgery ◽

10.3171/jns.1980.53.5.0710 ◽

1980 ◽

Vol 53 (5) ◽

pp. 710-713 ◽

Cited By ~ 8

Author(s):

Nancy Epstein ◽

Vallo Benjamin ◽

Richard Pinto ◽

Gleb Budzilovich

Keyword(s):

Spinal Cord ◽

Computerized Tomography ◽

Residual Tumor ◽

Cord Compression ◽

Transthoracic Approach ◽

Content Type ◽

Benign Osteoblastoma ◽

Posterior Laminectomy ◽

Subtotal Removal ◽

Fine Print

✓ A patient with osteoblastoma of the T-11 vertebral body presented with symptoms of spinal cord compression. Six weeks after an emergency laminectomy and subtotal removal, spinal computerized tomography disclosed residual tumor, which was totally removed via a combined anterior transthoracic approach and posterior laminectomy.

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