Eficacia de la artrodesis en el abordaje posterior de la mielopatía cervical: estudio comparativo de una serie de 36 casos

Pérez-López, Carlos; Isla, Alberto; Álvarez, Fernándo; Sarmiento, M.A.; Pérez-Alvarez, Marcelino; García-Raya, Pilar

doi:10.1016/s1130-1473(01)70686-0

Cited by 11 publications

(2 citation statements)

References 38 publications

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“…Several authors have demonstrated equivalent rates of postoperative neurologic recovery and improvement in CLF and CLP, 12 , 33 – 35 though CLP is suspected to result in reduced ROM,36 and there have been conflicting reports of which procedure is more advantageous with respect to the rate of postoperative kyphosis. 33 , 35 – 37 A 2001 independent matched-cohort analysis of CLF versus CLP concluded that CLP may be the preferable procedure owing to reduced complication rates and improved functional outcomes. 11 However, a more recent study has suggested that both procedures offer effective and comparable functional outcomes, and that a RCT would be necessary to determine the superiority of either modality.…”

Section: Discussionmentioning

confidence: 99%

Retrospective cost analysis of cervical laminectomy and fusion versus cervical laminoplasty in the treatment of cervical spondylotic myelopathy

Warren¹,

Ricart-Hoffiz²,

Andres³

et al. 2013

The International Journal of Spine Surgery

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BackgroundCervical laminoplasty (CLP) and posterior cervical laminectomy and fusion (CLF) are well-established surgical procedures used in the treatment of cervical spondylotic myelopathy (CSM). In situations of clinical equipoise, an influential factor in procedural decision making could be the economic effect of the chosen procedure. The object of this study is to compare and analyze the total hospital costs and charges pertaining to patients undergoing CLP or CLF for the treatment of CSM.MethodsWe performed a retrospective review of 81 consecutive patients from a single institution; 55 patients were treated with CLP and 26 with CLF. CLP was performed via the double-door allograft technique that does not require implants, whereas laminectomy fusion procedures included metallic instrumentation. We analyzed 10,682 individual costs (HC) and charges (HCh) for all patients, as obtained from hospital accounting data. The Current Procedural Terminology codes were used to estimate the physicians’ fees as such fees are not accounted for via hospital billing records. Total cost (TC) therefore equaled the sum of the hospital cost and the estimated physicians’ fees.ResultsThe mean length of stay was 3.7 days for CLP and 5.9 days for CLF (P < .01). There were no significant differences between the groups with respect to age, gender, previous surgical history, and medical insurance. The TC mean was $17,734 for CLP and $37,413 for CLF (P < .01). Mean HCh for CLP was 42% of that for CLF, and therefore the mean charge for CLF was 238% of that for CLP (P < .01). Mean HC was $15,426 for CLP and $32,125 for CLF (P < .01); the main contributor was implant cost (mean $2582).ConclusionsOur study demonstrates that, in clinically similar populations, CLP results in reduced length of stay, TC, and hospital charges. In CSM cases requiring posterior decompression, we demonstrate CLP to be a less costly procedure. However, in the presence of neck pain, kyphotic deformity, or gross instability, this procedure may not be sufficient and posterior CLF may be required.

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Section: Discussionmentioning

confidence: 99%

Retrospective cost analysis of cervical laminectomy and fusion versus cervical laminoplasty in the treatment of cervical spondylotic myelopathy

Warren¹,

Ricart-Hoffiz²,

Andres³

et al. 2013

The International Journal of Spine Surgery

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“…Twenty-two (71%) of 31 patients had improvement in Nurick score of ≥1 point at a minimum of 6 months of followup (mean 15 months). Perez-Lopez et al compared 19 patients that underwent laminectomy to 17 that underwent laminectomy and fusion [24]. They found similar improvement in Nurick scores but, there was an increase in postoperative kyphosis with in the laminectomy alone cohort (24%) compared to the laminectomy and fusion group (7%).…”

Section: Treatment Outcomes For Cervical Spondylotic Myelopathymentioning

confidence: 99%

Operative Outcomes for Cervical Myelopathy and Radiculopathy

Galbraith

Butler

Dolan

et al. 2012

Advances in Orthopedics

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Cervical spondylotic myelopathy and radiculopathy are common disorders which can lead to significant clinical morbidity. Conservative management, such as physical therapy, cervical immobilisation, or anti-inflammatory medications, is the preferred and often only required intervention. Surgical intervention is reserved for those patients who have intractable pain or progressive neurological symptoms. The goals of surgical treatment are decompression of the spinal cord and nerve roots and deformity prevention by maintaining or supplementing spinal stability and alleviating pain. Numerous surgical techniques exist to alleviate symptoms, which are achieved through anterior, posterior, or circumferential approaches. Under most circumstances, one approach will produce optimal results. It is important that the surgical plan is tailored to address each individual's unique clinical circumstance. The objective of this paper is to analyse the major surgical treatment options for cervical myelopathy and radiculopathy focusing on outcomes and complications.

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