Neuropsychological Improvement in Patients with Cervical Spondylotic Myelopathy after Cervical Laminoplasty

There is a report that 60% of patients suffer from neck and shoulder symptoms following unilateral open type laminoplasty. As for French-window-open type cervical laminoplasty, however, postoperative nuchal pain has not been fully investigated. The purpose of this study is to describe the prevalence and severity of nuchal pain following French-window-open type cervical laminoplasty, and to investigate the pain's influencing factor. Eighty-three cases with spastic tetraparesis due to cervical spondylotic myelopathy or ossification of posterior longitudinal ligament were followed. We interviewed these patients, at three months after surgery and again at one year after surgery, about the existence of nuchal pain, its laterality, and whether treatment was needed. Nuchal complaints remained in 56 out of 83 patients at three months and in 37 out of 78 patients at one year following surgery. There was no correlation between the complaint and disease, age, sex, blood loss, or method of muscle reconstruction. The side for which the patient complained of pain coincided with the approached side, and the magnitude of the complaint correlated with operation time. The results suggest that the cause of the nuchal pain is damage to the posterior neck muscles by retractor.

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Risk Factors for Poor Outcome of Cervical Laminoplasty for Cervical Spondylotic Myelopathy in Patients with Diabetes

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.n.00064 ◽

2014 ◽

Vol 96 (24) ◽

pp. 2049-2055 ◽

Cited By ~ 23

Author(s):

Masaaki Machino ◽

Yasutsugu Yukawa ◽

Keigo Ito ◽

Taro Inoue ◽

Akinori Kobayakawa ◽

...

Keyword(s):

Risk Factors ◽

Cervical Spondylotic Myelopathy ◽

Cervical Laminoplasty ◽

Poor Outcome ◽

Patients With Diabetes

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Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty

Advances in Orthopedics ◽

10.1155/2012/508534 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Brett A. Braly ◽

David Lunardini ◽

Chris Cornett ◽

William F. Donaldson

Keyword(s):

Surgical Technique ◽

Cervical Spondylotic Myelopathy ◽

Surgical Intervention ◽

Treatment Options ◽

Clinical Signs ◽

Signs And Symptoms ◽

Technical Difficulty ◽

Cervical Laminoplasty ◽

Open Door ◽

Clinical Signs And Symptoms

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

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Cervical Laminoplasty as a Management Option for Patients With Cervical Spondylotic Myelopathy

Neurosurgery ◽

10.1227/01.neu.0000371981.83022.b1 ◽

2010 ◽

Vol 67 (2) ◽

pp. 272-277 ◽

Cited By ~ 16

Author(s):

Anthony L. Petraglia ◽

Vasisht Srinivasan ◽

Michelle Coriddi ◽

M. Gordon Whitbeck ◽

James T. Maxwell ◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Medical Center ◽

Demographic Data ◽

Adult Population ◽

Postoperative Outcome ◽

Outcome Data ◽

Consecutive Series ◽

Cervical Laminoplasty ◽

Presenting Symptoms

Abstract BACKGROUND Cervical spondylotic myelopathy (CSM) is one of the leading causes of spinal cord dysfunction in the adult population. Laminoplasty is an effective decompressive procedure for the treatment of CSM. OBJECTIVE We present our experience with 40 patients who underwent cervical laminoplasty using titanium miniplates for CSM. METHODS We performed a retrospective review of the medical records of a consecutive series of patients with CSM treated with laminoplasty at the University of Rochester Medical Center or Rochester General Hospital. We documented patient demographic data, presenting symptoms, and postoperative outcome. Data are also presented regarding the general cost of constructs for a hypothetical 3-level fusion. RESULTS Forty patients underwent cervical laminoplasty; all were available for follow-up. The mean number of levels was 4. All patients were myelopathic, and 17 (42.5%) had signs of radiculopathy preoperatively. Preoperatively, 62.5% of patients had a Nurick grade of 2 or worse. The average follow-up was 31.3 months. The median length of stay was 48 hours. On clinical evaluation, 36 of 40 patients demonstrated an improvement in their myelopathic symptoms; 4 were unchanged. Postoperative kyphosis did not develop in any patients. CONCLUSION The management of CSM for each of its etiologies remains controversial. As demonstrated in our series, laminoplasty is a cost-effective, decompressive procedure for the treatment of CSM, providing a less destabilizing alternative to laminectomy while preserving mobility. Cervical laminoplasty should be considered in the management of multilevel spondylosis because of its ease of exposure, ability to decompress, effective preservation of motion, maintenance of spinal stability, and overall cost.

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Cervical rotation before and after hinge-door cervical laminoplasty for cervical spondylotic myelopathy

Journal of Craniovertebral Junction and Spine ◽

10.4103/jcvjs.jcvjs_25_19 ◽

2019 ◽

Vol 10 (2) ◽

pp. 114

Author(s):

SachinA Borkar ◽

Ravi Sreenivasan ◽

Ravi Sharma ◽

Sumit Sinha ◽

SLeve Joseph ◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Cervical Laminoplasty ◽

Before And After ◽

Cervical Rotation

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

Indian Journal of Neurosurgery ◽

10.4103/2277-9167.118119 ◽

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.

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