Expansion Open-door Laminoplasty With Foraminotomy Versus Anterior Cervical Discectomy and Fusion for Coexisting Multilevel Cervical Myelopathy and Unilateral Radiculopathy

Zhao, Fang; Tian, Rong; Sun, Tiansheng; Yadav, Sandip Kumar; Hu, Wei; Xie, Shui-qing

doi:10.1097/bsd.0000000000000074

Cited by 24 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…nlarged laminectomy with lateral mass screw xation (EL-LMSF) was performed by removing the inside edge of facet joints and decompressing the nerve foramina. As reported in our previous studies, posterior expansion open-door laminoplasty with foraminotomy showed improved clinical outcomes for coexisting unilateral radiculopathy and multilevel cervical myelopathy [4] . Therefore, this study aimed to further investigate and compare the surgical e cacy of EL-LMSF and anterior cervical corpectomy decompression and fusion (ACCF) for the treatment of patients with bilateral nerve root compression and multilevel spinal cord compression associated with kyphosis.…”

supporting

confidence: 83%

“…However, the optimal surgical treatment of multilevel CMR remains controversial due to the complications and adverse outcomes of each surgical approach [1][2][3] . Anterior surgery seems to be a radical surgical option, but it is also accompanied by a high incidence of spinal cord injury, fusion failure, and adjacent segment degeneration [4] . Traditional posterior laminoplasty or laminectomy is not su cient to decompress nerve root compression and even causes stretching of the nerve root due to backward shifting of the spinal cord.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Enlarged Laminectomy with Lateral Mass Screw Fixation in Relieving Nerve Root Symptoms and Correcting Kyphosis for Cervical Myelopathy and Radiculopathy

Zhao

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Purpose This study aimed to compare the surgical efficacy of enlarged laminectomy with lateral mass screw fixation (EL-LMSF) and anterior cervical corpectomy decompression and fusion (ACCF) for multilevel cervical myelopathy and radiculopathy (CMR) related to kyphosis. Methods We retrospectively analyzed 75 patients treated with either EL-LMSF or ACCF surgery for multilevel CMR in the study. Operative time, blood loss, the incidence of surgical complications, and the magnitude of the regional sagittal Cobb angle were compared. According to the Japanese Orthopedic Association (JOA) Scores, Visual Analog Scale (VAS) scores for the neck, radiological parameters and clinical function scores pre- and postoperatively were compared in each patient to analyze the surgical efficacy of EL-LMSF and ACCF. Results The JOA score, VAS score for neck pain and C2-C7 angle before the operation were not significantly different between the ACCF group and the EL-LMSF group. The ACCF group was performed over a mean of 2.39 levels (range, 2–3 levels) and all patients were followed up for more than 1 year after surgery. Analysis of the follow-up data showed a shorter operation time (103 ± 22 min vs. 125 ± 37 min, P = 0.000) and less blood loss (78 ± 15 ml vs. 226 ± 31 ml, P = 0.000) in the ACCF group than the EL-LMSF group. Patients treated with EL-LMSF indicated lower VAS scores for the neck (1.3 ± 1.7 vs. 3.3 ± 1.3, P = 0.003) and better cervical lordosis (10.7 ± 4.2° vs. 8.5 ± 3.5°, P = 0.013) than the ACCF group.No difference in the JOA score (14.1 ± 1.7 vs. 13.5 ± 2.1, P = 0.222) was noted between the two groups. During the follow-up period, 15.2% of patients in the ACCF group had complications, including 2 cases with transient dysphagia, 1 case with C5 palsy, 1 case with axial symptoms, and 1 with screw pullout. In the EL-LMSF group, only 9.5% of cases experienced complications, including 3 cases of axial pain and 1 case of epidural hematoma. Conclusions EL-LMSF for the treatment of multilevel CMR is an effective and safe strategy for relieving nerve root symptoms and restoring cervical curvature. However, high-quality, large-scale clinical trials with long-term follow-up are urgently warranted.

show abstract

supporting

confidence: 83%

mentioning

confidence: 99%

Evaluation of Enlarged Laminectomy with Lateral Mass Screw Fixation in Relieving Nerve Root Symptoms and Correcting Kyphosis for Cervical Myelopathy and Radiculopathy

Zhao

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…In meta-analyses, postoperative JOA scores and recovery rates were similar between the 2 groups, especially when the canal occupation was <50% to 60%. [ 18 ] Fang et al [ 19 ] reported similar clinical outcomes in ACDF and expansion open-door laminoplasty for treating multilevel cervical myelopathy. But, Dobran et al [ 20 ] reported that patients treated with posterior fixation had chronic pain associated with stiffness of the neck after cervical spinal trauma surgery.…”

Section: Discussionmentioning

confidence: 99%

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

et al. 2020

View full text Add to dashboard Cite

We conducted a retrospective study to compare the clinical and radiological results of anterior cervical discectomy and fusion (ACDF) and posterior laminoplasty for two-level localized ossification of the posterior longitudinal ligament (OPLL). ACDF and posterior laminoplasty are performed for localized OPLL at the disc and vertebral body levels, respectively. Eighty six patients with two-level localized OPLL who underwent surgery from January 2011 to December 2016 were retrospectively investigated (41, ACDF group; 45, laminoplasty group). Clinical outcomes were reviewed, and radiologic results such as occupying ratio (OR), space available in the spinal cord, cranial and caudal OPLL-to-disc distance (ODD)/posterior body height (PBH) ratios, segmental angle, C2–C7 Cobb angle, T1 slope, C2–C7 sagittal vertical axis (SVA), and range of motion were investigated. Patients were followed-up for an average of 42.7 ± 10.5 months. Clinical outcomes, postoperative OR, and space available in the spinal cord were significantly improved at the final follow-up in both groups. Preoperatively, the OR and cranial and caudal ODD/PBH ratios were not significantly different between the groups. Compared to pre-operative values, differences in the segmental and C2–C7 Cobb angles at the final follow-up were statistically significant for the ACDF group ( P < .05). The mean operative time, bleeding volume, and the duration of hospitalization were significantly lower in the ACDF group than in the laminoplasty group ( P < .05). Complications occurred in 1 ACDF case and in 5 laminoplasty cases. Both ACDF and laminoplasty provided satisfactory clinical and radiologic outcomes for two-level localized OPLL. However, ACDF was associated with a lower operation time, bleeding loss, duration of hospitalization, and complications.

show abstract

“…Реализация этих преимуществ осуществляется только посредством непременного использования винтовой фиксации [17], которая является относительно более безопасной, даже при наличии мальпозиций элементов металлоконструкции [14,15]. Следует отметить, что, по нашим данным, задняя стабилизация имеет более низкое соотношение осложнений, в том числе имплантатозави-симых, с необходимостью ревизионных вмешательств для их устранения [18,19]. Однако их тяжесть в некоторых случаях может быть выше в сравнении с передней стабилизацией [14].…”

Section: Discussionunclassified

Comparative characteristic of anterior and posterior stabilization of the cervical spine during surgical interventions

et al. 2020

View full text Add to dashboard Cite

Objective. To analyze possibilities and limitations of various stabilization technologies in the surgical treatment of cervical spine pathology. Material and Methods. Study design: retrospective monocentric observational analysis. Level of evidence: 3b (UK Oxford, version 2009). Diagnostic and treatment data are presented for 433 patients operated on using stabilization systems: patients in Group 1 (n = 228) underwent anterior fixation, those in Group 2 (n = 175)-posterior fixation with polyaxial screw systems, and in Group 3 (n = 30)-combined (anterior and posterior) fixation.

show abstract

Expansion Open-door Laminoplasty With Foraminotomy Versus Anterior Cervical Discectomy and Fusion for Coexisting Multilevel Cervical Myelopathy and Unilateral Radiculopathy

Abstract: The 2 surgical procedures have similar clinical effects in treating multisegmental CMUR. However, the EOLF group demonstrated shorter operative time, less blood loss, and fewer complications; therefore, it proved to be a more effective and safer method.

Cited by 24 publications

References 23 publications

Evaluation of Enlarged Laminectomy with Lateral Mass Screw Fixation in Relieving Nerve Root Symptoms and Correcting Kyphosis for Cervical Myelopathy and Radiculopathy

Evaluation of Enlarged Laminectomy with Lateral Mass Screw Fixation in Relieving Nerve Root Symptoms and Correcting Kyphosis for Cervical Myelopathy and Radiculopathy

Anterior cervical discectomy and fusion vs posterior laminoplasty for the treatment of myelopathy due to two-level localized ossification of the posterior longitudinal ligament

Comparative characteristic of anterior and posterior stabilization of the cervical spine during surgical interventions

Contact Info

Product

Resources

About