scholarly journals Double Dome Laminoplasty: A Novel Technique for C2 Decompression

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 882-888
Author(s):  
Dong-Ho Lee ◽  
Gian Karlo P. Dadufalza ◽  
Jong-Min Baik ◽  
Sehan Park ◽  
Jae Hwan Cho ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Neck Pain ◽  
Cervical Myelopathy ◽  
Analogue Scale ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Patient Reported ◽  
Laminar Fracture ◽  
Cervical Spine Alignment ◽  
New Surgical Technique

Objective: To introduce a new surgical technique - double dome laminoplasty for decompression of the entire C2 lamina and preservation of an extensor muscle insertion.Methods: Eleven consecutive cervical myelopathy patients due to ossification of the posterior longitudinal ligament involving the Axis (C2) area were contained at this study. Direct decompression was evaluated as an increasing rate in space available cord (%) and posterior cord shift (mm) at C2 level. The Japanese Orthopaedic Association (JOA) score, visual analogue scale, and C2–7 Cobb angle in a neutral lateral x-ray were analyzed.Results: The mean increase in space available for spinal cord at the C2 level, average posterior cord shift, and JOA recovery rate were 69.7%, 5.3 ± 0.15 mm, and 58.0%, respectively. Cervical lordotic angle was maintained in all patients. One patient reported neck pain (visual analogue scale 6) postoperatively. No specific complications such as C2 laminar fracture or insufficient decompression were observed.Conclusion: We recommend double dome laminoplasty for treating patients with cervical myelopathy involving the C2 area to avoid C2 laminectomy, reduce postoperative neck pain, and maintain lordotic cervical spine alignment.

A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2019 ◽  
Vol 9 (3Jun) ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

Is there a difference in range of motion, neck pain, and outcomes in patients with ossification of posterior longitudinal ligament versus those with cervical spondylosis, treated with plated laminoplasty?

2013 ◽  
Vol 35 (1) ◽  
pp. E9 ◽  
Author(s):  
Takahito Fujimori ◽  
Hai Le ◽  
John E. Ziewacz ◽  
Dean Chou ◽  
Praveen V. Mummaneni
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
San Francisco ◽  
Japanese Orthopaedic Association ◽  
Minimum Clinically Important Difference ◽  
Posterior Longitudinal Ligament ◽  
Flexion Angle ◽  
Radiographic Outcomes ◽  
The Mean

Object There are little data on the effects of plated, or plate-only, open-door laminoplasty on cervical range of motion (ROM), neck pain, and clinical outcomes. The purpose of this study was to compare ROM after a plated laminoplasty in patients with ossification of posterior longitudinal ligament (OPLL) versus those with cervical spondylotic myelopathy (CSM) and to correlate ROM with postoperative neck pain and neurological outcomes. Methods The authors retrospectively compared patients with a diagnosis of cervical stenosis due to either OPLL or CSM who had been treated with plated laminoplasty in the period from 2007 to 2012 at the University of California, San Francisco. Clinical outcomes were measured using the modified Japanese Orthopaedic Association (mJOA) scale and neck visual analog scale (VAS). Radiographic outcomes included assessment of changes in the C2–7 Cobb angle at flexion and extension, ROM at C2–7, and ROM of proximal and distal segments adjacent to the plated lamina. Results Sixty patients (40 men and 20 women) with an average age of 63.1 ± 10.9 years were included in the study. Forty-one patients had degenerative CSM and 19 patients had OPLL. The mean follow-up period was 20.9 ± 13.1 months. The mean mJOA score significantly improved in both the CSM and the OPLL groups (12.8 to 14.5, p < 0.01; and 13.2 to 14.2, respectively; p = 0.04). In the CSM group, the mean VAS neck score significantly improved from 4.2 to 2.6 after surgery (p = 0.01), but this improvement did not reach the minimum clinically important difference (MCID). Neither was there significant improvement in the VAS neck score in the OPLL group (3.6 to 3.1, p = 0.17). In the CSM group, ROM at C2–7 significantly decreased from 32.7° before surgery to 24.4° after surgery (p < 0.01). In the OPLL group, ROM at C2–7 significantly decreased from 34.4° to 20.8° (p < 0.01). In the CSM group, the change in the VAS neck score significantly correlated with the change in the flexion angle (r = − 0.31) and the extension angle (r = − 0.37); however, it did not correlate with the change in ROM at C2–7 (r = − 0.1). In the OPLL group, the change in the VAS neck score did not correlate with the change in the flexion angle (r = 0.03), the extension angle (r = − 0.17), or the ROM at C2–7 (r = − 0.28). The OPLL group had a significantly greater loss of ROM after surgery than did the CSM group (p = 0.04). There was no significant correlation between the change in ROM and the mJOA score in either group. Conclusions Plated laminoplasty in patients with either OPLL or CSM decreases cervical ROM, especially in the extension angle. Among patients who have undergone laminoplasty, those with OPLL lose more ROM than do those with CSM. No correlation was observed between neck pain and ROM in either group. Neither group had a change in neck pain that reached the MCID following laminoplasty. Both groups improved in neurological function and outcomes.

scholarly journals A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

2018 ◽  
Author(s):  
I Rezaei ◽  
M Razeghi ◽  
S Ebrahimi ◽  
S Kayedi ◽  
A Rezaeian Zadeh
Keyword(s):  
Virtual Reality ◽  
Visual Analogue Scale ◽  
Neck Pain ◽  
Analogue Scale ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Repeated Measure ◽  
Balance Test ◽  
Proprioceptive Training ◽  
Neck Disability

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

scholarly journals Comparison of Laminoplasty and Posterior Fusion Surgery for Cervical Ossification of Posterior Longitudinal Ligament

2021 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Shiro Imagama ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Kenichiro Sakai ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Perioperative Complications ◽  
Clinical Status ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Posterior Fusion ◽  
Postoperative Outcomes ◽  
Intensity Change ◽  
Multivariable Logistic Regression Analysis ◽  
Significant Difference

Abstract This prospective multicenter study formed by the Japanese Ministry of Health, Labour and Welfare at 27 institutions aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL). Controversy exists regarding the role of instrumented fusion in the context of posterior surgical decompression for OPLL. Among the 479 patients enrolled, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, and increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments showed no significant differences. The overall risk of perioperative complications was lower in LM (odds ratio [OR] 0.40, p = 0.006), and C5 palsy was significantly lower in LM (OR 0.11, p = 0.0002) than in PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients with PF was significantly smaller than in those with LM. However, multivariable logistic regression analysis showed no significant difference in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in LM group than in the PF group (OR 2.73, p = 0.0002). LM and PF for cervical myelopathy due to OPLL resulted in comparable postoperative outcomes at two years after surgery.

Checkmate 577:Health-related quality of life (HRQoL) in a randomized, double-blind phase III study of nivolumab (NIVO) versus placebo (PBO) as adjuvant treatment in patients (pts) with resected esophageal or gastroesophageal junction cancer (EC/GEJC).

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 167-167
Author(s):  
Eric Van Cutsem ◽  
Prianka Singh ◽  
James M. Cleary ◽  
Ronan Joseph Kelly ◽  
Markus H. Moehler ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Visual Analogue Scale ◽  
Repeated Measures ◽  
Analogue Scale ◽  
Gastroesophageal Junction ◽  
Neoadjuvant Chemoradiotherapy ◽  
Phase Iii ◽  
Meaningful Improvement ◽  
Utility Index ◽  
Patient Reported

167 Background: NIVO is the first adjuvant therapy to provide a statistically significant and clinically meaningful improvement in disease-free survival (DFS) versus PBO in resected EC/GEJC following neoadjuvant chemoradiotherapy as demonstrated by CheckMate 577. NIVO was well tolerated with an acceptable safety profile. This analysis provides additional information on the exploratory HRQoL endpoints in this clinical trial. Methods: The effect of NIVO versus PBO on HRQoL, including general and disease-related symptoms, functioning, disease burden, and overall QoL, was assessed using FACT-E and EQ-5D-3L patient-reported outcome (PRO) questionnaires administered at baseline (BL), every 4 weeks during the 12-month treatment period, and at post-treatment follow-up visits (up to 2 years after last dose). Longitudinal change from BL in PRO scores over 12 months was assessed using descriptive statistics. Additionally, mixed model for repeated measures and time to deterioration analyses evaluated the difference between treatment with NIVO and PBO (data not shown). Results: 794 pts with EC/GEJC were randomized 2:1 to NIVO (n = 532) or PBO (n = 262). PRO completion rates were ≥ 95% at BL and ~ 90% at 12 months on treatment. Mean (SD) BL HRQoL scores were similar between treatment arms for the FACT-E total score (NIVO: 133.40 [20.97]; PBO: 134.03 [20.40]); esophageal cancer subscale (ECS; NIVO: 50.2 [9.3]; PBO: 50.1 [8.9]); EQ-5D Visual Analogue Scale (NIVO: 70.4 [22.3]; PBO: 69.1 [24.1]); and EQ-5D Utility Index (NIVO: 0.820 [0.179]; PBO: 0.831 [0.163]) based on the UK value set. Descriptive analyses showed a trend for increases from baseline at most time points through week 49 for both NIVO and PBO treatment groups for FACT-E total score, ECS, and EQ-5D Visual Analogue Scale and Utility Index. Conclusions: Preliminary results from CheckMate 577 demonstrated that pts on NIVO treatment showed trends of improvement in both esophageal-specific and general HRQoL. Similar trends were also observed in pts treated with PBO over 1 year. Pts treated with NIVO did not experience a reduction in HRQoL, further supporting clinical data to demonstrate treatment benefit and tolerability for adjuvant NIVO in pts with resected EC/GEJC. Clinical trial information: NCT02743494.

scholarly journals The effects of photobiomodulation therapy for the treatment of dentin hypersensitivity

2020 ◽  
Author(s):  
Erika Michele dos Santos Araújo ◽  
Bárbara Fávero Araújo Lima ◽  
Júlia Gomes Lúcio de Araújo ◽  
Fernanda Cristina Nogueira Rodrigues ◽  
Stella Ferreira do Amaral ◽  
...  
Keyword(s):  
Case Report ◽  
Visual Analogue Scale ◽  
Low Power ◽  
Diode Laser ◽  
Male Patient ◽  
Analogue Scale ◽  
Dentin Hypersensitivity ◽  
Cervical Lesions ◽  
Patient Reported ◽  
Power Diode

Objective: This case report proposes a treatment for dentin hypersensitivity (DH) using photobiomodulation (PBT) with low power diode laser. Methods and Results: Male patient, 28 years old, reporting “dental sensitivity,” diagnosed by anamnesis and intraoral examination, with non-carious cervical lesions (NCCL) and DH on teeth 15 to 25, with different pain intensities, measured with visual analogue scale (VAS). For DH treatment, a PBT was proposed, with 808nm, 100mW, 20s and 2J of energy, applied during 3 sessions, with one-week interval and reevaluation after 30 days. After the first session, the patient reported improvement of sensitivity in all teeth, except for 15, that remained sensitive even during the reevaluation. Conclusion: PBT was effective in DH treatment, with desensitization being observed for 30 days in 90% of treated teeth.

Radiculopathy of C-5 after anterior decompression for cervical myelopathy

2005 ◽  
Vol 3 (3) ◽  
pp. 210-217 ◽  
Author(s):  
Minoru Ikenaga ◽  
Jitsuhiko Shikata ◽  
Chiaki Tanaka
Keyword(s):  
Cervical Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Manual Muscle Testing ◽  
Radiographic Evaluation ◽  
Anterior Decompression ◽  
Content Type ◽  
Muscle Testing ◽  
Anterior Corpectomy ◽  
Fine Print

Object. The authors conducted a study to examine the incidence and causes of postoperative C-5 radiculopathy, and they suggest preventive methods for C-5 palsy after anterior corpectomy and fusion. Methods. The authors included in the study 18 patients with postoperative C-5 radiculopathy from 563 patients who underwent anterior decompression and fusion for cervical myelopathy. There were 10 cases of ossification of the posterior longitudinal ligament (OPLL) and eight cases of cervical spondylotic myelopathy (CSM). All patients received conservative treatment. Posttreatment full recovery was present in eight patients, and Grade 3/5 strength was documented in six in whom some weakness remained. Radiographic evaluation revealed that the C3–4 and C4–5 cord compression was significantly more severe in patients with paralysis than in those without paralysis. The incidence of paralysis was higher in patients with OPLL than in those with CSM (chi-square test, p = 0.03). The incidence of paralysis increased in parallel with the number of fusion levels (correlation coefficient r = 0.94). Multivariate analysis revealed that the final manual muscle testing (MMT) value was closely related to the preoperative MMT value (computed t value 4.17; p < 0.01) and preoperative Japanese Orthopaedic Association (JOA) score for cervical myelopathty (computed t value, 2.75; p < 0.05). Conclusions. Preexisting severe stenosis at C3–4 or C4–5 in patients with OPLL is a risk factor for paralysis. Preoperative muscle weakness and a low JOA score are factors predictive of poor recovery.

Risk factors for closure of lamina after open-door laminoplasty

2008 ◽  
Vol 9 (6) ◽  
pp. 530-537 ◽  
Author(s):  
Morio Matsumoto ◽  
Kota Watanabe ◽  
Takashi Tsuji ◽  
Ken Ishii ◽  
Hironari Takaishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Neck Pain ◽  
Cervical Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Pain Patient ◽  
Open Door ◽  
Vertebral Level ◽  
Recovery Rates

Object This retrospective study was conducted to evaluate the prevalence and clinical consequences of postoperative lamina closure after open-door laminoplasty and to identify the risk factors. Methods Eighty-two consecutive patients with cervical myelopathy who underwent open-door laminoplasty without plates or spacers in the open side (Hirabayashi's original method) were included (62 men and 20 women with a mean age of 62 years and a mean follow-up of 1.8 years). In 67 patients the cause of cervical myelopathy was spondylotic myelopathy, and in 15 it was caused by ossification of posterior longitudinal ligament. Radiographic measurements were made of the anteroposterior diameters of the spinal canal and vertebral bodies from C3–6, and the presence of kyphosis were assessed. Lamina closure was defined as ≥ 10% decrease in the canal-to-body ratio at the final follow-up compared with that immediately after surgery at ≥ 1 vertebral level. The impact of lamina closure on neck pain, patient satisfaction, Japanese Orthopaedic Association scores, and recovery rates were also evaluated. Results The mean canal-to-body ratio at C3–6 was 0.69–0.72 preoperatively, 1.25–1.28 immediately after surgery, and 1.18–1.24 at the final follow-up examination. Lamina closure was observed in 34% of patients and was not associated with sex, age, or cause of myelopathy, but was significantly associated with the presence of preoperative kyphosis (p = 0.014). Between patients with and without lamina closure, there was no significant difference in preoperative (9.7 ± 3.1 vs 10.6 ± 2.5) and postoperative (13.7 ± 2.4 vs 13.1 ± 2.7) Japanese Orthopaedic Association scores, recovery rates (53.9 ± 29.9% vs 44.3 ± 29.5%), neck pain scores (3.5 ± 0.7 vs 3.3 ± 1.0), or patient satisfaction level (4.0 ± 1.4 vs 4.8 ± 1.0). Conclusions Lamina closure at ≥ 1 vertebral level occurred in 34% of patients. Although patients with lamina closure obtained equivalent recovery from myelopathy in a short-term follow-up, they tended to be less satisfied with surgery compared with those who did not have closure. The only significant risk factor identified was the presence of preoperative cervical kyphosis, and preventative methods for lamina closure, therefore, should be considered for patients with preoperative kyphosis.

Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion

2011 ◽  
Vol 14 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Jason M. Highsmith ◽  
Sanjay S. Dhall ◽  
Regis W. Haid ◽  
Gerald E. Rodts ◽  
Praveen V. Mummaneni
Keyword(s):  
Neck Pain ◽  
Japanese Orthopaedic Association ◽  
Length Of Hospital Stay ◽  
Posterior Longitudinal Ligament ◽  
Complication Rates ◽  
Cervicothoracic Junction ◽  
Pain Scores ◽  
Vas Scores ◽  
The Mean ◽  
Cervical Stenotic Myelopathy

Object Cervical stenotic myelopathy due to spondylosis or ossification of the posterior longitudinal ligament is often treated with laminoplasty or cervical laminectomy (with fusion). The goal of this study was to compare outcomes, radiographic results, complications, and implant costs associated with these 2 treatments. Methods The authors analyzed the records of 56 patients (age range 42–81 years) who were surgically treated for cervical stenosis. Of this group, 30 underwent laminoplasty and 26 underwent laminectomy with fusion. Patients who had cervical kyphosis or spondylolisthesis were excluded. An average of 4 levels were instrumented in the laminoplasty group and 5 levels in the fusion group (p < 0.01). Forty-two percent of the fusions crossed the cervicothoracic junction, but no laminoplasty instrumentation crossed the cervicothoracic junction, and it only reached C-7 in one-third of the cases. Preoperative and postoperative Nurick grades and modified Japanese Orthopaedic Association (mJOA) scores were obtained. Outcomes were also assessed with neck pain visual analog scale (VAS) scores and the Odom outcome criteria. Postoperative length of stay, complications, and implant costs were calculated. Results The mean duration of follow-up, average patient age, and length of hospital stay were similar for both groups. The mean Nurick scores were also similar in the 2 groups and improved an average of 1.4 points in both (p < 0.01 for preoperative-postoperative comparison in each group). The mean mJOA scores improved 2.7 points in laminoplasty patients and 2.8 points in fusion patients (p < 0.01 for each group). The mean VAS scores for neck pain did not change significantly in the laminoplasty cohort (3.2 ± 2.8 [SD] preoperatively vs 3.4 ± 2.6 postoperatively, p = 0.50). In the fusion cohort, the mean VAS scores improved from 5.8 ± 3.2 to 3.0 ± 2.3 (p < 0.01). Excellent or good Odom outcomes were observed in 76.7% of the patients in the laminoplasty cohort and 80.8% of those in the fusion cohort (p = 0.71). In the fusion group, complications were twice as common and implant costs were nearly 3 times as high as in the laminoplasty group. When cases involving fusions crossing the cervicothoracic junction were excluded, analysis showed similar complication rates in the 2 groups. Conclusions Patients treated with laminoplasty and patients treated with laminectomy and fusion had similar improvements in Nurick scores, mJOA scores, and Odom outcomes. Patients who underwent fusion typically had higher preoperative neck pain scores, but their neck pain improved significantly after surgery. There was no significant change in the neck pain scores of patients treated with laminoplasty. Our series suggests cervical fusion significantly reduces neck pain in patients with stenotic myelopathy, but that the cost of the implant and rate of reoperation are greater than in laminoplasty.

Clinical results of cervical myelopathy in patients older than 80 years of age: evaluation of spinal function with motor evoked potentials

2009 ◽  
Vol 11 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Nobuhiro Tanaka ◽  
Kazuyoshi Nakanishi ◽  
Yoshinori Fujimoto ◽  
Hirofumi Sasaki ◽  
Naosuke Kamei ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Motor Evoked Potentials ◽  
Japanese Orthopaedic Association ◽  
Motor Evoked Potential ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Conduction Time ◽  
Average Recovery Rate ◽  
The Mean ◽  
Spinal Function

Object In this prospective analysis the authors describe the clinical results of surgical treatment in patients > 80 years of age in whom spinal function was evaluated with motor evoked potential (MEPs) monitoring. Methods The authors included 57 patients > 80 years of age who were suspected of having cervical myelopathy. The mean age of the patients was 83.0 years (range 80–90 years). The central motor conduction time (CMCT) was calculated from the latencies of the MEPs following transcranial magnetic stimulation and from M and F waves following peripheral nerve stimulation. Results Preoperative electrophysiological evaluation demonstrated significant elongation of CMCT or abnormalities in MEP waveforms in 37 patients (65%), and 35 patients of these underwent laminoplasty. In 30 patients cervical spondylotic myelopathy was diagnosed and 5 patients ossification of the posterior longitudinal ligament was diagnosed. The preoperative mean Japanese Orthopaedic Association Scale score was 8.6 (range 3–12.5) and the mean postoperative score was 12.6 (range 6–14.5) with an average recovery rate of 45% (range −21 to 100%). There were no major complications in any of the patients during the operative period and there were no cases of death resulting from operative intervention. Conclusions Sufficient clinical results are expected even in patients with myelopathy who are older than 80 years of age, provided the patients are correctly selected by electrophysiological evaluation with MEPs and CMCT.

Sign in / Sign up

Export Citation Format

Share Document