A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results

Arantes, Aluízio Augusto; Silva, Geraldo Alves da; Malheiros, José Augusto; Goncalves, Fernando Flavio; Magaldi, Marcelo; Santiago, Erica; Nicolato, Arthur; Gusmão, Sebastião Nataniel Silva

doi:10.1590/0004-282x20130240

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…A number of laminoplasty procedures have been developed for the treatment of CSM. Many studies have shown that the surgical outcome of laminoplasty are satisfactory131115182225). However, postoperative complications may arise, including decreased cervical ROM and loss of cervical lordotic alignment, all of which may significantly impair the quality of life4510).…”

Section: Discussionmentioning

confidence: 99%

The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy

Cho

2016

Korean J Spine

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ObjectiveDegenerative diseases of the spine, such as cervical spondylotic myelopathy (CSM), are increasing among the old age population, and surgical treatment of CSM is becoming more and more common. The aim of this study was to investigate how functional recovery can be influenced by anterior compression of the spinal cord (ACS) after laminoplasty for treatment of patients with CSM.MethodsWe retrospectively analyzed 32 patients admitted to Ewha Womans Mok-Dong Hospital with CSM who underwent open-door laminoplasty from January 2012 to December 2014. We divided patients into 2 groups according to whether ACS was or not preoperatively. Each group was analyzed clinical and radiological parameters which were Japanese Orthopedic Association (JOA) scores and its recovery rate, sagittal alignment and range of motion (ROM).ResultsThe mean duration of symptom was 11.2 months (range, 6-22 months). A significant difference in recovery rate of the total JOA score was shown between the 2 groups, especially upper extremity motor function. No difference in preoperative JOA score between the 2 groups, but recovery rate of each group was 20.05%±18.1%, 32.21%±25.4%, statistically significant (p<0.005). Upper motor and sensory function was not significantly different in the 2 groups. Preoperative, postoperative and preservation of ROM was 44.3°±10.1°, 41.8°±15.7°, 87.9%±35.4% each at ACS (-) group. A significant difference in postoperative ROM was identified between ACS (-) and ACS (+) group. Postoperative anterior compression of the spinal cord was recognized 14 cases which were classified from its causes.Conclusion Cervical ROM decreased significantly after laminoplasty, but 85.3% of the preoperative ROM was preserved. The postoperative reduction of ROM in group with anterior compression of spinal cord was identified.

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Section: Discussionmentioning

confidence: 99%

The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy

Cho

2016

Korean J Spine

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“…Cervical laminoplasty is widely used to treat cervical myelopathy with OPLL or spondylosis. There have been many reports regarding satisfactory surgical outcomes using this procedure 1 , 6 , 7 , 10 , 12 , 16 , 19) . Double-door laminoplasty was originally devised by Kurokawa in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…Cervical expansive laminoplasty was originally carried out using spinous processes as spacers. Since development of classic open-door laminoplasty with the use of sutures, the procedure has been modified to reduce complications such as restenosis, axial symptoms, and segmental motor paralysis 1 , 12 , 13 , 14 , 20) .…”

Section: Introductionmentioning

confidence: 99%

Box-Shape Cervical Expansive Laminoplasty: Clinical and Radiological Outcomes

Park

Zhang²,

Lee³

2014

Korean J Spine

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ObjectiveBox-shape cervical expansive laminoplasty is a procedure that utilizes a Miniplate® or Maxpacer® to achieve maximal canal expansion. This method is expected to show much larger canal expansion and good clinical outcome. So we investigated the clinical and radiological outcome of Box-shape cervical expansive laminoplasty.MethodsBetween June 2008 and July 2013, we performed cervical expansive laminoplasty in 87 and 48 patients using the Box-shape cervical expansive laminoplasty, respectively. We analyzed the clinical results of these operations using the Japanese Orthopedic Association (JOA) scoring system and by assessing the position of intralaminar screws with postoperative computed tomography (CT) at POD-6 months.ResultsA total of 48 patients with ossification of the posterior longitudinal ligament (OPLL) (36 pts), cervical spondylotic myelopathy (CSM) (12 pts) were enrolled. Overall JOA scores improved from 11.49 to 14.22 at POD-6 months (OPLL: 11.32 -->14.3; CSM: 12-->14). Postoperative CT scans were performed in 39 patients at 177 levels for a total of 354 screws. The malpositioning rate of intralaminar screws was 3.4% and hardware-related neurologic complications did not occur.ConclusionBox-shape cervical expansive laminoplasty creates maximal spinal canal expansion and leads to improved cervical myelopathy. The use of intralaminar screws to fix the remodeled lamina-facet does not represent a significant difficulty.

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Analysis of the outcome in patients with cervical spondylotic myelopathy, undergone canal expansive laminoplasty supported with instrumentation in a group of Indian population – a prospective study

et al. 2016

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Background Chronic compression of the cervical spinal cord leads to a clinical syndrome of cervical spondylotic myelopathy (CSM). Clinical symptoms of cervical spondylotic myelopathy (CSM) or cervical myeloradiculopathies result in spinal cord and root dysfunction. The primary aims of surgical intervention for multilevel myelopathy are to decompress the spinal cord and maintain stability of the cervical spine. Secondary aims are to minimize complications which include long-term pain and motion loss. Laminoplasty as either single-door or double-door technique and with/without instrumentation is an established mode of surgical treatment.The purpose of our study was to evaluate the result of single-door laminoplasty technique, supported with instrumented fixation in patients with multilevel degenerative cervical spondylotic myeloradiculopathy. MethodsA prospective and without control study has been conducted in the institution in 17 patients with CSM, operated by canal expansive single-door laminoplasty (Hirabayashi technique) between April 2010 to April 2015. These patients were followed up for at least 3 years with both clinical and radiographic evaluations. ResultsOn clinical evaluation, 15 of the 17 patients (87%) experienced relief of their symptoms. According to the Nurick classification, 11 patients' demonstrated improvement by one grade, two patients improved by two grades, two patients were unchanged and two had worsening of the Nurick grade. ConclusionsThe results of this study regarding the use of open-door laminoplasty with instrumented fixation suggest that this technique is a satisfactory alternative for cases of multilevel cervical spondylotic myelopathy without deformation. Level of EvidenceLevel III therapeutic study.keywords: cervical spine, spondylotic myeloradiculopathy, single-door laminoplasty, instrumented fixation, nurick clinical evaluation volume 10 article 17

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A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results

Cited by 6 publications

References 28 publications

The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy

The Change of Range of Motion at Anterior Compression of the Cervical Cord after Laminoplasty in Patients with Cervical Spondylotic Myelopathy

Box-Shape Cervical Expansive Laminoplasty: Clinical and Radiological Outcomes

Analysis of the outcome in patients with cervical spondylotic myelopathy, undergone canal expansive laminoplasty supported with instrumentation in a group of Indian population – a prospective study

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