Cervical alignment following laminoplasty for cervical spondylotic myelopathy (original) (raw)
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Journal of Craniovertebral Junction and Spine, 2021
To monitor changes in cervical parameters before and after laminoplasty surgery. Cervical parameters and health-related quality-of-life (HRQOL) values that may be affected after laminoplasty were examined before and after surgery. The clinical and radiological course of these values was monitored, and their interaction with all spinal radiological parameters was revealed. Materials and Methods: Nineteen patients who underwent clinical and radiological evaluation for 2 years were followed in this study. Neck disability index, visual analog scale, and short form 36 scores were determined to evaluate HRQOL. For radiological parameters, the C0-C2 angle, C2-C7 angle, cervical sagittal vertical axis, T1 slope angle, neck tilt (NT) and thoracic inlet angle were used. The results of the 4-month, 1 year and 2year follow-ups were statistically evaluated. Results: Both the HRQOL and cervical radiological parameters deteriorated in the first 4 months and returned to normal in the 2 year. Statistically, all parameters were meaningful (P < 0.05), except for NT. Conclusion: Cervical parameters and HRQOL values, which deteriorated in the early period, recovered in the late period in the long-term follow-up of patients undergoing laminoplasty. The important point is that preoperative cervical parameters suitable for laminoplasty should be present, and spinopelvic parameters should be normal.
Surgical neurology, 2004
Laminoplasty is a well-recognized technique for decompressing the cervical spine in cases of spondylotic myelopathy and ossification of the posterior longitudinal ligament. This technique, originally popularized in Asia, is becoming more widespread, but to date there have been few reports of clinical series from North American centers. Retrospectively we reviewed (1986-2001) 204 cases of open door laminoplasty. All patients presented with symptoms and magnetic resonance imaging (MRI) findings consistent with myelopathy secondary to multisegmental cervical stenosis with spondylosis and underwent decompression from C3 to C7. Improvement in myelopathy was assessed with the Nurick Score. Average age was 63 years (range 36 to 92). Follow-up averaged 16 months. Postoperatively, Nurick scores improved by 1 point in 78 patients, 2 points in 37 patients, 3 points in 7 patients, and 4 points in 5 patients; 74 patients experienced no improvement, and 3 patients deteriorated by one point. There...
Turkish neurosurgery, 2009
Cervical laminoplasty is an effective procedure. We describe the technique of open-door and french-door cervical laminoplasty and present our clinical results. All patients undergoing laminoplasty at our clinic during the 1997- 2008 period were included in the study. All patients had myeloradiculopathy. Neurological functions and recovery in myelopathy in patients were evaluated using the Nurick score. Pre- and postoperative kyphotic evaluation was measured using the sagittal tangent method. Peri- and postoperative complications were recorded. Clinical evaluation showed that all patients had reduced postoperative complaints compared to their complaints before the procedure. Average time of surgery was 180 min. Average blood loss in surgeries was 300 cc. According to the Nurick classification, no improvement was observed in seven patients; nine patients showed improvement of one grade; and three patients showed an improvement of two grades. Temporary C5 nerve root paralysis was obser...
Is cervical lordosis relevant in laminoplasty?
The Spine Journal, 2013
BACKGROUND CONTEXT: Laminoplasty aims to decompress the spinal cord and stabilize the cervical spine in patients with multilevel cervical lesions. Not every patient with cervical compressive myelopathy is a good candidate for laminoplasty. Most studies recommend that neutral or kyphotic alignments are contraindications for laminoplasty. However, cervical sagittal alignment does not have a strong and consistent effect on the clinical outcomes of laminoplasty. Moreover, many reports on the effect of cervical sagittal alignment did not designate the ideal definition of alignment and used different definitions of lordosis. PURPOSE: To identify the effect of preoperative cervical alignment according to two different definitions after midline splitting double-door laminoplasty. STUDY DESIGN: Retrospective cohort study. PATIENT SAMPLE: From August 2008 to September 2010, 58 patients were diagnosed with cervical myelopathy and treated with midline splitting double-door laminoplasty. OUTCOME MEASURES: The clinical results were assessed with the modified Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and visual analog scale (VAS) and were compared to analyze the rate of change between preoperative and postoperative values. Postoperative radiological results at the final follow-up examinations were compared between groups to obtain the change in range of motion and sagittal alignment. METHOD: The effect of cervical alignment on JOA, NDI, and VAS scales and also on change of alignment and change of range of motion (ROM) at the final follow-up examinations was analyzed statistically between two groups according to two different definitions such as Toyama classification and Cobb angle. RESULTS: No difference was found between the two groups according to Toyama classification in terms of the postoperative improvement rate of the modified JOA score (p5.086), decreasing rate of the VAS (p5.940) or NDI (p5.211), postoperatively. Additionally, no difference was found for the decreasing rate of ROM (p5.427) or sagittal alignment (p5.864) based on the radiological evaluation results. Also, there was no difference between two groups according to Cobb angle in terms of the modified JOA score (p5.743), VAS (p5.548), or NDI (p5.32), postoperatively. Additionally, no difference was found for the ROM (p51.000) or sagittal alignment (p5.440) based on the radiological evaluation results. CONCLUSIONS: Despite nonlordosis cervical sagittal alignment, double-door laminoplasty would be effective for patients with cervical myelopathy because of cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament. Furthermore, sagittal alignment is not the FDA device/drug status: Not applicable.
Turkish Neurosurgery, 2017
technique was modified and developed by Hirabayashi and the double-door laminoplasty technique by Kurokawa (5,20). Although cervical laminoplasty is a motion-preserving procedure, several studies have reported some complications and problems such as axial neck pain, kyphotic deformity, and reduction of cervical range of motion (ROM) on long-term follow-up (6,8,20). █ INTRODUCTION L aminoplasty is a good alternative to laminectomy for the treatment of cervical spinal stenosis with/ without myelopathy (3,18,20,21,36-38). The expansive laminoplasty technique was first described by Oyama et al. (26). After that, the unilateral open-door laminoplasty AIm: Some restriction and complications, such as progression of kyphosis, incidence of axial neck pain and decrease of postoperative cervical range of motion are concern. We designed this retrospective clinical study to evaluate the effect of laminoplasty by preserving the muscle attachments of C2 and C7 spinous processes on range of motion (ROM), axial neck pain and cervical lordosis. mATERIAl and mEThODS: Twenty-seven cases with cervical spondylotic myelopathy underwent open-door laminoplasty with the protection of muscle attachments to the C2 and C7 spinous process and laminae between 2007 and 2013. At the end of the followup, cases were evaluated with preoperative and postoperative modified Japanese Orthopedic Association (mJOA) scores, recovery rate, ROM, lordosis angle and visual analogue scale (VAS). Also, patients were divided into two groups and evaluated according to the magnetic resonance imaging (MRI) findings, with or without T2 signal change. RESUlTS: The mean age of the patients was 66 years. The mean follow-up duration was 25 months. The postoperative mJOA scores were significantly higher than the preoperative mJOA scores (p<0.001). The recovery rate was 57.4%. Although the postoperative VAS score was higher than the preoperative VAS score and the mean postoperative ROM was lower than the preoperative ROM there was no significant difference between preoperative and postoperative VAS score and ROM (p>0.05). The postoperative lordosis angle was significantly lower than the preoperative lordosis angle (p<0.05). There were no significant differences regarding the postoperative lordosis angle, ROM and mJOA scores with or without T2 signal change on MRI. CONClUSION: Protection of the anatomic structures around the cervical spine such as the muscles and ligaments provides us better results regarding ROM and cervical axial pain.
Surgical Neurology International, 2021
Background: We reviewed the literature comparing the indications/efficacy of laminectomy (LA) with or without fusion versus laminoplasty (LP) in the treatment of cervical spondylotic myelopathy (CSM). Methods: We identified 14 studies in PubMed/Medline to include in our analysis. Outcomes were assessed utilizing the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), Neck Disability Index, and Nurick scale. Variables studied included ossification of the posterior longitudinal ligament (OPLL), cervical range of motion (ROM), the C2-C7 sagittal Cobb angle, the Ishihara index, and the Hirabayashi scale. Patients with cervical trauma/fracture, infection, or tumor were excluded from the study. Results: In these 14 studies, there were no significant differences between LA and LP groups in terms of preoperative versus postoperative: JOA scores (e.g., including the improvement rate), VAS scores, and ROM. However, the LA patients demonstrated greater postoperative cervic...
Factors affecting the surgical results of expansive laminoplasty for cervical spondylotic myelopathy
International Orthopaedics, 2002
We studied the outcome of expansive laminoplasty in 37 patients with cervical spondylotic myelopathy. Patients were divided into two groups according to the recovery rate (RR) -a 'good' group (n=19), and a 'fair' group (n=18). Patients in the good group showed a greater pre-operative Japanese Orthopaedic Association (JOA) score, a greater compression ratio, and a larger Pavlov ratio (P<0.05). The presence of high signal intensity on MRI proved to be of no prognostic importance.
Long-term clinical and radiological follow-up after laminectomy for cervical spondylotic myelopathy
Surgical neurology international, 2015
The role of laminectomy in the surgical treatment of cervical spondylotic myelopathy (CSM) is established even though postoperative cervical sagittal balance changes and a risk for long-term instability have been described. The aim of the present study is to investigate its clinical efficacy and the radiological outcome in the long-term. The authors retrospectively reviewed consecutive cases of patients with CSM, who underwent cervical laminectomy between 1995 and 2010 at the Hospital São João (n = 106). Clinical files were consulted, and the patients reassessed in order to collect information on complaints, previous neurological deficits, surgery and its complications. Subjective and objective clinical evaluation (by three myelopathy scores) and imaging studies were undertaken in order to assess the long-term cervical sagittal curvature and presence of instability. After applying exclusion criteria, 57 patients were able to complete the follow-up. A favorable statistically signific...
Laminoplasty for Cervical Spondylotic Myelopathy
The Journal of Spinal Surgery, 2014
Cervical spondylotic myelopathy (CSM) is a commonly treated either by uninstrumented laminectomy, carrying the risk of postoperative instability, or by anterior or posterior decompression with fusion resulting in postoperative stiffness and possibly adjacent segment degeneration.
Neurosurgical Focus, 2013
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 la...