Effect of Lamina Open Angles in Expansion Open-door Laminoplasty on the Clinical Results in Treating Cervical Spondylotic Myelopathy

Zhang, Hang; Lu, Shouliang; Sun, Tiansheng; Yadav, Sandip Kumar

doi:10.1097/bsd.0b013e3182695295

Cited by 32 publications

(17 citation statements)

References 15 publications

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“…In a study by Zhang et al,26) although no significant difference was found in clinical outcomes between two groups divided according to the ΔLA (15°–30° vs. ≥ 30°), C5 palsy and axial symptoms were less frequent in the group with a ΔLA of 15°–30°. In the present study, two cases of transient C5 palsy were observed in the group with a ΔLA of 25% to 50%.…”

Section: Discussionmentioning

confidence: 85%

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Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

et al. 2016

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BackgroundLaminoplasty is a surgical procedure frequently performed for cervical myelopathy. We investigated correlations between changes in the anteroposterior diameter (APD) of the spinal canal, spinal canal area (SCA), and laminar angle (LA) and clinical outcomes of laminoplasty.MethodsOf the 204 cervical myelopathy patients who underwent laminoplasty from July 2010 to May 2015, 49 patients who were evaluated with pre- and postoperative computed tomography of the cervical vertebrae were included. The average age of the patients was 60.4 years (range, 31 to 82 years), and the average duration of follow-up was 31.6 months (range, 9 to 68 months). Changes in the APD and SCA were measured at the middle of the vertebral body. Changes in LA were measured where both pedicles were clearly visible. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) score and visual analog scale score for pain preoperatively (1 day before surgery) and postoperatively (last outpatient visit) and examining postoperative complications.ResultsThe APD showed an average of 54.7% increase from 11.5 to 17.8 mm. The SCA showed an average of 57.7% increase from 225.9 to 356.3 mm2. The LA increased from 34.2° preoperatively to 71.9° postoperatively. The JOA score increased from an average of 9.1 preoperatively to 13.4 postoperatively. Three patients were found to have hinge fractures during surgery. Postoperative complications, including two cases of C5 palsy, were recorded. The correlation coefficient between the LA change and JOA score improvement was −0.449 (p < 0.05). Patients with a < 33° (25%) increase in the LA showed the most significant clinical improvement.ConclusionsPatients with a < 33° (25%) change in the LA after laminoplasty with a titanium miniplate showed the most significant clinical improvement. Thus, LA changes can be useful in predicting the clinical outcome of laminoplasty.

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Section: Discussionmentioning

confidence: 85%

“…In the present study, two cases of transient C5 palsy were observed in the group with a ΔLA of 25% to 50%. Zhang et al26) reported that the group with a ΔLA of 15°–30° had a high reclosure rate. However, there was no case of reclosure in our study population.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

et al. 2016

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“…In recent years, scholars [6] have kept trying to reduce the occurrence of AS by improving the operation, including retaining the C7 ligament, determining if the vertebral plate door should be single or double, deciding whether the vertebral plate and segments for the opening door should be retained, and determining whether it should be C3-6 or extended to segment C3-7. Some other scholars [7,8] have studied the occurrence of cervical posterior AS, including the change of postoperative cervical curvature, the change of ligament and deep muscles, and the possible influence of age and sex on postoperative AS. Noboru et al [9] believe that in the occurrence of cervical posterior AS, retaining the C7 ligament will play an important role, but Takashi et al [10] have improved the method for peeling the deep paraspinal muscles and cutting off the ligament so as to retain the deep muscles as much as possible and reduce the probability of the occurrence of AS.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Study on Axial Symptoms and Imaging Changes in Paraspinal Muscles after Cervical Posterior Open-door Laminoplasty

Yin

Han

et al. 2018

Z Orthop Unfall

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We believe that axial symptoms after cervical spine surgery does not affect the recovery of neurological function. There is a process of acute or subacute enlargement of paraspinal muscles on segments C3/4 and C4/5 after the operation, while the results of the follow-up visits show that there is a gradual process of atrophy in local posterior muscles, which may be related to axial symptoms. The degree of pimelosis of the neck paraspinal muscles may have no relationship with axial symptoms.

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“…At the time of acute recirculation, the nerve cells may be chemically damaged by reactive oxygen 92,93) . In contrast, in the theory of nerve root injury, the anterior rootlet or nerve root may be mechanically compressed and/or distracted 58, [94][95][96][97][98][99][100][101] .…”

Section: B Postoperative C5 Palsymentioning

confidence: 99%

Development and Achievement of Cervical Laminoplasty and Related Studies on Cervical Myelopathy

Hirabayashi

Kitagawa

Yamamoto

et al. 2020

Spine Surg Relat Res

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Cervical laminoplasty (CL) is one of the surgical methods via the posterior approach for treating patients with multilevel affected cervical myelopathy (CM). The main purpose of CL is to decompress the cervical spinal cord by widening the narrowed spinal canal, combined with preserving the posterior anatomical structures to the degree possible and preserving the widened space stably. During the development and improvement of spine surgeries including CL, various studies on CM have progressed and useful achievements have been obtained: (1) posterior cervical spine fixation systems that can be used in combination with CL simultaneously have been developed; (2) various materials to stably maintain the enlarged spinal canal have been developed; (3) the main influential factors on the surgical results are the inner factors of the patients, such as the patient's age and the disease duration; (4) various surgical methods to preserve the function of the posterior cervical muscles have been tried to avoid postoperative kyphotic changes of the cervical spine; (5) postoperative complications, such as C5 palsy and axial pain, have been examined, and the countermeasures have been tried; (6) K-line on lateral X-ray films has been applied to evaluate the indication of CL in patients with CM due to ossification of the posterior longitudinal ligament (OPLL) preoperatively; and (7) the method and idea of CL have been adapted to surgeries at the thoracic and lumbar spine. However, some issues remain to be resolved, such as the deterioration of neurological findings, especially in patients with continuous or mixed-type OPLL, the postoperative kyphotic-directional alignment change of the cervical spine, C5 palsy, and axial pain.

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Effect of Lamina Open Angles in Expansion Open-door Laminoplasty on the Clinical Results in Treating Cervical Spondylotic Myelopathy

Cited by 32 publications

References 15 publications

Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

A Clinical Study on Axial Symptoms and Imaging Changes in Paraspinal Muscles after Cervical Posterior Open-door Laminoplasty

Development and Achievement of Cervical Laminoplasty and Related Studies on Cervical Myelopathy

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