CERVICAL SPONDYLOTIC MYELOPATHY TREATED BY OBLIQUE CORPECTOMY

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 674-682 ◽  
Author(s):  
Talat Kiris ◽  
Cumhur Kilinçer
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Spinal Cord ◽  
Good Alternative ◽  
Morbidity Rate ◽  
Japanese Orthopedic Association Score ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Oblique Corpectomy ◽  
Four Levels

Abstract OBJECTIVE Anterolateral partial oblique corpectomy (OC) aims to decompress the cervical spinal cord without subsequent fusion and saves the patient from graft-, instrument-, and fusion-related complications. Although it is a promising technique, there are few studies dealing with its efficacy and safety. METHODS In this prospective study, 40 consecutive patients underwent an OC (one to four levels from C3 to C7) for cervical spondylotic myelopathy; they ranged in age from 43 to 78 years (mean, 55 yr). The average follow-up period was 59 months (range, 24–98 mo). Clinical and radiological data were analyzed to assess the results and find possible factors related to outcomes. RESULTS Thirty-seven (92.5%) of the 40 patients improved by the 6-month follow-up examination according to the Japanese Orthopedic Association score. The improvement was the most prominent in lower extremity dysfunction. Recovery was positively correlated with the preoperative Japanese Orthopedic Association score (r = 0.37, P = 0.018). Permanent Horner's syndrome developed in four patients (10%). During the long-term follow-up period, neurological improvement was maintained and there were no signs of postoperative instability, posture change, or axial pain. CONCLUSION OC for treating multilevel cervical spondylotic myelopathy achieved good results with a low morbidity rate. The results of the current study suggest that OC is a good alternative to conventional median corpectomy and fusion techniques in selected cases.

Postoperative Magnetic Resonance Imaging Can Predict Neurological Recovery After Surgery for Cervical Spondylotic Myelopathy: A Prospective Study With Blinded Assessments

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. 362-368 ◽  
Author(s):  
Babak Arvin ◽  
Sukhvinder Kalsi-Ryan ◽  
Alina Karpova ◽  
David Mercier ◽  
Julio C. Furlan ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Short Form ◽  
Berg Balance Scale ◽  
Resonance Imaging ◽  
Japanese Orthopedic Association Score ◽  
Walking Test ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Signal Change ◽  
Grip Test

Abstract BACKGROUND: Factors that can predict the recovery of cervical spondylotic myelopathy (CSM) patients postoperatively are of significant interest to physicians and patients and their families. Magnetic resonance imaging (MRI) scans are a common method of examination after surgery, and thus of interest as a predictor of outcome. OBJECTIVE: To investigate whether findings on MRI at 6 months postoperatively could predict recovery at 1 year in CSM patients. METHODS: In 52 consecutive prospective patients, MRI was performed preoperatively and 6 months postoperatively. T1 and T2 signal change (area, height, and segmentation) and spinal cord re-expansion were measured. Outcome measures evaluated at 1 year postoperatively were compared with preoperative values. Univariate and stepwise multiple regressions were undertaken. RESULTS: Using univariate analysis, patients whose cord failed to re-expand had poorer outcome according to the modified Japanese Orthopedic Association score and Nurick score (P = .014) and grip test (P = .006) postoperatively. Stepwise multivariate regression showed lack of cord re-expansion to be predictive of prognosis postoperatively in the modified Japanese Orthopedic Association score (P = .013) and Berg Balance Scale (P = .014), and walking test (P = .011). Postoperative hyperintense T2 signal change was predictive of worse outcome on the Berg Balance Scale (P = .014) and walking test (P = .020), Nurick score (P = .001), and Short Form-36 scores (P = .020). In cases in which the T2 signal intensified, there was a poorer outcome on Nurick scores (P = .013), grip test (P = .017), and Short Form-36 scores (P = .030). CONCLUSION: Findings on postoperative MRI at 6 months is of predictive value in determining outcomes in CSM patients. The persistence and type of T2 signal change and lack of re-expansion of the cord correlate with poorer recovery and likely reflect irreversible structural changes in the spinal cord.

scholarly journals A Prospective, Randomized Trial Comparing Expansile Cervical Laminoplasty and Cervical Laminectomy and Fusion for Multilevel Cervical Myelopathy

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. 264-277 ◽  
Author(s):  
Glen R. Manzano ◽  
Gizelda Casella ◽  
Michael Y. Wang ◽  
Steven Vanni ◽  
Allan D. Levi
Keyword(s):  
Range Of Motion ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Cervical Laminoplasty ◽  
Japanese Orthopedic Association Score ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Canal Area ◽  
Cervical Laminectomy ◽  
Laminectomy And Fusion

Abstract BACKGROUND: Controversy exists as to the best posterior operative procedure to treat multilevel compressive cervical spondylotic myelopathy. OBJECTIVE: To determine clinical, radiological, and patient satisfaction outcomes between expansile cervical laminoplasty (ECL) and cervical laminectomy and fusion (CLF). METHODS: We performed a prospective, randomized study of ECL vs CLF in patients suffering from cervical spondylotic myelopathy. End points included the Short Form-36, Neck Disability Index, Visual Analog Scale, modified Japanese Orthopedic Association score, Nurick score, and radiographic measures. RESULTS: A survey of academic North American spine surgeons (n = 30) demonstrated that CLF is the most commonly used (70%) posterior procedure to treat multilevel spondylotic cervical myelopathy. A total of 16 patients were randomized: 7 to CLF and 9 to ECL. Both groups showed improvements in their Nurick grade and Japanese Orthopedic Association score postoperatively, but only the improvement in the Nurick grade for the ECL group was statistically significant (P < .05). The cervical range of motion between C2 and C7 was reduced by 75% in the CLF group and by only 20% in the ECL group in a comparison of preoperative and postoperative range of motion. The overall increase in canal area was significantly (P < .001) greater in the CLF group, but there was a suggestion that the adjacent level was more narrowed in the CLF group in as little as 1 year postoperatively. CONCLUSION: In many respects, ECL compares favorably to CLF. Although the patient numbers were small, there were significant improvements in pain measures in the ECL group while still maintaining range of motion. Restoration of spinal canal area was superior in the CLF group.

Calculating Ex-ante Utilities From the modified Japanese Orthopedic Association Score

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eric X. Jiang ◽  
Felicity E. Fisk ◽  
Kevin Taliaferro ◽  
Markian A. Pahuta
Keyword(s):  
Japanese Orthopedic Association Score ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Ex Ante

scholarly journals Surgery in multisegmental cervical spondylotic myelopathy: Outcome analysis in a series of 65 patients

2013 ◽  
Vol 02 (02) ◽  
pp. 170-174
Author(s):  
K.B. Shankar ◽  
Shashank Kale ◽  
Bhawani Sharma ◽  
Sumit Sinha
Keyword(s):  
Clinical Outcome ◽  
Surgical Approach ◽  
Cervical Spondylotic Myelopathy ◽  
Outcome Analysis ◽  
Cervical Laminoplasty ◽  
Japanese Orthopedic Association ◽  
Excellent Outcome ◽  
The Mean ◽  
Cervical Plating

Abstract Multi-segmental cervical spondylotic myelopathy (MS-CSM) can be dealt with by either anterior or posterior approaches. The aim of study was to analyze the surgical outcomes of MS-CSM treated by either anterior cervical discectomy with fusion and cervical plating (ACDF) or cervical laminoplasty (LP). Sixty-five patients with MS-CSM (two or more levels) underwent either ACDF (n=13) or LP (n=52). ACDF was performed in patients having these criteria: (i) three or less levels involved, (ii) myeloradiculopathy, (iii) pre-dominant anterior compression radiologically, (iv) <50 years age. LP was chosen in: (i) more than three levels involved (ii) posterior compression radiologically, (iii) >50 years age. Patients were evaluated pre- and post-operatively on the basis of modified Japanese Orthopedic Association (mJOA) scoring and Hirabayashi formula. Thirty-five patients were followed up (8 in ACDF group and 27 in LP group). The mean follow-up period was 37.5 months (12.5-54 months). The mean pre-operative mJOA score in the ACDF group and the LP group was 11±2.62 and 10.6±2.04, respectively. The mean final post-operative mJOA score in the ACDF group (n=8) in follow-up was 14.12±2.36 (P<0.05) and in the LP group (n=27) was 14.63±1.64 (P<0.05). 86% had good-to-excellent outcome while 8.5% had poor outcome. Overall, the mean recovery was 64.73±18.9%. On analyzing two groups separately, the mean recovery in the ACDF group was 59.62±24.2, while in the LP group was 66.25±17.3 (P<0.05). The choice of ACDF and LP in MS-CSM depends on pre-operative clinical and radiological parameters. If the surgical approach is chosen correctly, the surgery in MS-CSM can result in significant improvement in the clinical outcome of these patients.

scholarly journals Reduction in range of cervical motion on serial long-term follow-up in patients undergoing oblique corpectomy for cervical spondylotic myelopathy

2013 ◽  
Vol 22 (7) ◽  
pp. 1509-1516 ◽  
Author(s):  
Mazda K. Turel ◽  
Sauradeep Sarkar ◽  
Krishna Prabhu ◽  
Roy T. Daniel ◽  
K. S. Jacob ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Long Term Follow Up ◽  
Oblique Corpectomy ◽  
Cervical Motion

Lateral approach to Thyroid: A Good Technique for Reoperative Thyroid Surgeryat

2016 ◽  
Vol 8 (2) ◽  
pp. 141-142 ◽  
Author(s):  
Duminda DMC Dissanayake ◽  
Ranil F Fernando ◽  
Iresha J Dissanayake
Keyword(s):  
Thyroid Surgery ◽  
Good Alternative ◽  
Lateral Approach ◽  
Morbidity Rate ◽  
Safe Alternative ◽  
Good Technique ◽  
Malignant Lesions ◽  
Reoperative Thyroid Surgery ◽  
Natural Tissue

ABSTRACT Introduction Thyroidectomy is the commonest endocrine surgical procedure undertaken throughout the world. Redo thyroidectomies are challenging procedures with a higher morbidity rate. Lateral approach to thyroid (LATT) is a good alternative to the standard midline exploration. The key to the technique is the development of the natural tissue plane between the strap muscle and the ipsilateral sternocleidomastoid muscle to explore the thyroid bed. A study was carried out to assess the efficacy, safety, and complication of LATT. Materials and methods Data on patients undergoing LATT in professorial surgical unit, Ragama from 2008 to 2015, were collected prospectively and analyzed. All procedures were done by a single surgeon. Results A total of 36 LATTs were done. Data from 32 people were collected, as 4 patients lost follow-up; 29 (90.6%) were females and 3 (9.4%) were males. Their age ranges between 28 and 61 (median 43.37). Three (9.4%) LATTs for parathyroid explorations and out of it one (3.1%) for redo parathyroid explorations were done. Nine (28.1%) cases were redo thyroidectomies and 18 (56.2%) were done with mini incision with lateral approach. Hemithyroidectomies were performed on 28 (87.5%) patients. Bilateral explorations were done on three (9.4%) patients and four (12.5%) lateral approaches were done for completion thyroidectomies for follicular malignant lesions. Transient clinical hypocalcemia was noticed in four (12.5%) patients and one (3.1%) developed hoarseness of voice, which was temporary; and none of them had complications like hematoma and postsurgical stridor. Conclusion Lateral approach to thyroid is a safe alternative to the standard approach for reexplorative thyroid surgery. How to cite this article Dissanayake DDMC, Fernando RF, Dissanayake IJ. Lateral approach to Thyroid: A Good Technique for Reoperative Thyroid Surgery. World J Endoc Surg 2016;8(2):141-142.

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