Laminoplastia expansiva: uma alternativa no tratamento da mielopatia espondilótica cervical

Andrade, Gustavo Cardoso de; Silveira, Roberto Leal; Arantes, Aluízio Augusto; Pinheiro, N.; Rocha, Eckstânio Marcos Melo

doi:10.1590/s0004-282x2005000600018

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Algumas técnicas, ao invés de tirar parte da vértebra como na laminectomia, consistem em usar a broca em toda extensão de um lado das lâminas vertebrais e só na cortical da lâmina contralateral, criando uma fratura em "galho verde" que permita elevar as lâminas e assim aumentando o diâmetro do canal vertebral, promovendo descompressão medular. Enxertos ósseos são usados para preencher espaço entre lâmina elevada e massa lateral 34 .…”

Section: Cirurgias Cervicais Posteriores Para Mielopatiasunclassified

“…Até infecções secundárias ao extravasamento de liquido cefalorraquidiano são bem baixas 35 . Apesar de estudos não entrarem em consenso sobre qual procedimento é melhor para o tratamento cirúrgico de mielopatias cervicais por meio de abordagem posterior, a laminoplastia ocasiona significativamente menos paralisia nervosa do que a laminectomia com fusão 34 , mostrando que talvez seja um procedimento de melhor escolha. É importante ressaltar também que independente da técnica cirúrgica, o sucesso do procedimento depende do conhecimento, do domínio de técnica e da destreza do cirurgião.…”

Section: Cirurgias Cervicais Posteriores Para Mielopatiasunclassified

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Tratamento Cirúrgico das Doenças Degenerativas da Coluna Cervical. Revisão de literatura

Chaar¹,

Escudeiro²,

Marinho³

et al. 2019

jbnc

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Section: Cirurgias Cervicais Posteriores Para Mielopatiasunclassified

Tratamento Cirúrgico das Doenças Degenerativas da Coluna Cervical. Revisão de literatura

Chaar¹,

Escudeiro²,

Marinho³

et al. 2019

jbnc

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

Arantes

Silva

Malheiros

et al. 2014

Arq. Neuro-Psiquiatr.

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Cervical degenerative myelopathy is a common condi tion affecting 2% of all hospital admissions according to a number of studies 1,2 . The two main causes of this condition are cervical spondylosis and ossification of the posterior longitudinal ligament (OPLL) 3 . Such conditions progress with age and can eventually result in the impairment of mul tilevel segments and multilevel cervical spondylotic mye lopathy (MCSM). ABSTRACT:The laminoplasty technique was devised by Hirabayashi in 1978 for patients diagnosed with multilevel cervical spondylotic myelopathy. Objective: To describe an easy modification of Hirabayashi's method and present the clinical and radiological results from a five-year followup study. Method and Results: Eighty patients had 5 levels of decompression (C3-C7), 3 patients had 6 levels of decompression (C2-T1) and 3 patients had 4 levels of decompression (C3-C6). Foraminotomies were performed in 23 cases (27%). Following Nurick`s scale, 76 patients (88%) improved, 9 (11%) had the same Nurick grade, and one patient worsened and was advised to undergo another surgical procedure. No deaths were observed. The mean surgery time was 122 min. Radiographic evaluation showed an increase in the mean sagittal diameter from 11.2 mm at pretreatment to 17.3 mm post surgery. There was no significant difference between pretreatment and post-surgery C2-C7 angles. Conclusions:This two-open-doors laminoplasty technique is safe, easy and effective and can be used as an alternative treatment for cases of multilevel cervical spondylotic myelopathy without instability.Keywords: laminoplasty, cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament. RESUMO:A laminoplastia é técnica clássica descrita por Hirabayashi em 1978 para descompressão do canal cervical sem utilizar prótese. A principal indicação é o tratamento da mielopatia espondilotica cervical sem instabilidade. Objetivo: Descrever modificação simples da técnica de laminoplastia clássica de Hirabayashi com resultados clínicos e radiográficos em 5 anos de acompanhamento. Resultados e Método: Foram acompanhados 86 pacientes. Em 80, foi feita descompressão por laminoplastia em 5 níveis (C3-C7); em 3, descompressão em 6 níveis (C2-T1); em 3, descompressao em 4 níveis (C3-C6). Em 23 casos (27%), foi realizada foraminotomia associada a descompressão medular. O acompanhamento dos pacientes foi feito utilizando a escala de Nurick. Em 76 pacientes (88%) houve melhora do grau de Nurick. Não houve mortalidade associada à técnica. O tempo médio do procedimento cirúrgico foi de 122 minutos. Em relação à avaliação radiográfica, houve aumento do diâmetro sagital médio do canal cervical de 11,2mm para 17,3mm. Não houve diferença estatística do ângulo C2-C7 nas avaliações antes e após o procedimento cirúrgico. Conclusão: A nova técnica de laminoplastia descrita no presente estudo foi segura, de fácil execução, efetiva, não utiliza protese e não há instabilidade do canal cervical.Palavras-chave: laminoplastia, mielopatia espondilotica cervical,...

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Quality of life in symptomatic cervical myelopathy after open-door laminoplasty

2015

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Objective: To analyze the results obtained by open-door laminoplasty using the Newbridge  /Blackstone plate, in cases of myelopathy associated with cervical lordosis. Methods: From December 2010 to October 2012, eight patients between the ages of 49 and 68 underwent open-door laminoplasty with the use of the Newbridge  fixation system for maintenance and stabilization of the cervical laminoplasty. Minimum follow-up was four months. For the evaluation of quality of life the questionnaire SF-36 was applied at the following times: preoperative, one month and three months after surgery associated with the subjective assessment of the patient regarding satisfaction with the procedure and with the Nurick neurological scale applied prior to surgery and three months later. Results: According to the SF-36, there was significant improvement in the domains functional ability, general health perceptions and emotional aspects over time; regarding physical limitations and social aspects there was no improvement in the first postoperative month, only in the third month. There were no statistically significant changes observed during the period covered by this study related to pain, vitality and mental health. According to Nurick scale, there was evidence of improvement in symptoms of cervical myelopathy. Based on the subjective evaluation of the patients, surprisingly, all patients were satisfied with the surgical procedure and the results. Conclusion: The open-door laminoplasty technique with rigid fixation to maintain the opening is useful in improving the symptoms of cervical myelopathy associated with lordosis, leading to improved quality of life and with a high degree of patient satisfaction and fewer complications.Keywords: Spinal cord diseases; Laminoplasty; Spine/surgery; Quality of life. RESUMO Objetivo: Analisar os resultados obtidos pela laminoplastia open-door com o uso da placa Newbridge

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Laminoplastia expansiva: uma alternativa no tratamento da mielopatia espondilótica cervical

Cited by 3 publications

References 17 publications

Tratamento Cirúrgico das Doenças Degenerativas da Coluna Cervical. Revisão de literatura

Tratamento Cirúrgico das Doenças Degenerativas da Coluna Cervical. Revisão de literatura

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

Quality of life in symptomatic cervical myelopathy after open-door laminoplasty

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