Laminoplasty in Motion: Evolving Techniques and Complications

Singleton, Ian M.; Piple, Amit S.; Crawford, B.S.; Mittal, Ashish; Rosinski, Alexander Anthony; Kondrashov, Dimitriy

doi:10.1055/s-0043-1769005

J Neurol Surg A Cent Eur Neurosurg

2023

DOI: 10.1055/s-0043-1769005

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Laminoplasty in Motion: Evolving Techniques and Complications

Ian M. Singleton

Amit S. Piple

B.S. Crawford

et al.

Abstract: Cervical laminoplasty is an increasingly popular surgical option for the treatment of cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL). Over the past few decades, there have been substantial developments in both surgical technique and hardware options. As the field of cervical surgery rapidly evolves, there is a timely need to reassess the evolving complications associated with newer techniques. This review aims to synthesize the available literature on cervi… Show more

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2024

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Cited by 2 publications

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Removal of Retro-Corporeal Compressive Pathology Using Guttering Osteotomy During Anterior Cervical Discectomy and Fusion

Lee,

Hwang,

Cho

et al. 2024

Clinical Spine Surgery

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Study Design: A retrospective cohort study. Objective: Guttering is a technique that creates a tunnel through the vertebral body adjacent to the endplate to remove compressive pathologies behind the vertebral body during anterior cervical discectomy and fusion (ACDF). In this study, we investigated cases of patients who underwent gutter-shaped osteotomy (guttering) to decompress retro-corporeal compressive lesions. Summary of Background Data: Retro-corporeal pathologies causing cord compression cannot be removed using conventional ACDF. Materials and Methods: A total of 217 patients who underwent ACDF to treat cervical myelopathy and were followed up for ≥1 year were retrospectively reviewed. The fusion rate, subsidence, neck pain visual analog scale (VAS), arm pain VAS, and neck disability index (NDI) were assessed. Results were compared between the guttering (patients for whom guttering was performed) and nonguttering (patients for whom guttering was not performed) groups. Results: Thirty-five patients (16.1%) were included in the guttering group, while 182 patients (83.8%) were included in the nonguttering group. Fusion rates assessed by interspinous motion (P=0.559) and bone bridging on computed tomography (CT) (P=0.541 and 0.715, respectively) were not significantly different between the 2 groups at 1 year after surgery. Furthermore, neck pain VAS (P=0.492), arm pain VAS (P=0.099), and NDI (P=1.000) 1 year after surgery did not demonstrate significant intergroup differences. All patients in the guttering group exhibited healed guttering on 1-year postsurgery CT. Conclusions: Guttering as an adjunct to ACDF could provide a more expansive workspace for complete decompression when compressive pathology extends retrocorporeal. This additional bone resection is not associated with increased pseudarthrosis or subsidence or related to aggravation of patient symptoms. Level of Evidence: Level III.

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Removal of Retro-Corporeal Compressive Pathology Using Guttering Osteotomy During Anterior Cervical Discectomy and Fusion

Lee,

Hwang,

Cho

et al. 2024

Clinical Spine Surgery

View full text Add to dashboard Cite

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Smoking Does Not Negatively Impact Outcomes Following Cervical Laminoplasty

Hou,

Croft,

Chanbour

et al. 2024

Clinical Spine Surgery

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Study Design: Retrospective cohort study. Objective: To assess the impact of smoking on outcomes following elective cervical laminoplasty for degenerative cervical myelopathy (DCM). Summary of Background Data: The detrimental effect of cigarette smoking on cervical spinal fusion surgery outcomes is well documented. However, the impact of smoking on outcomes following nonfusion cervical spine procedures is unknown. One commonly utilized nonfusion technique for cervical decompression is laminoplasty. Methods: Adult smokers or nonsmokers who underwent primary elective laminoplasty for DCM were included. The propensity score (PS) was constructed for being a current smoker based on covariates. Only patients contained in the PS overlapped region were included in the analysis set. Patient-reported outcomes (PROs) at baseline and 12 months postoperation included Visual Analog Scale (VAS) neck and arm pain, neck disability index (NDI)%, EuroQol-5 Dimension (EQ-5D), and modified Japanese Orthopedic Association (mJOA) scores. Other outcomes included perioperative complications, 3-month readmissions/reoperations, and patient satisfaction. Wilcoxon and Pearson tests were used to compare outcomes between smokers and nonsmokers. Results: The study included 132 patients: 30 were smokers (22.7%) and 102 were nonsmokers (77.3%). No significant differences were found at baseline between groups in demographics or medical history. Smokers had significantly worse baseline VAS neck pain (5.7±3.2 vs. 4.4±3.04, P=0.028) and arm pain (5.7±3.5 vs. 4.3±3.2, P=0.045) scores, but all other baseline PROs were not statistically different between groups. No differences were found between smokers and nonsmokers in any 12-month PRO, or in rates of perioperative complications, 3-month readmissions, or 3-month reoperations. On multivariable logistic regression analysis, smoking had no significant impact on any outcome of interest. Conclusion: Clinical and PROs following elective laminoplasty for DCM are not significantly different between smokers and nonsmokers. Laminoplasty should be considered a good surgical option in smokers presenting with DCM.

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Laminoplasty in Motion: Evolving Techniques and Complications

Cited by 2 publications

References 55 publications

Removal of Retro-Corporeal Compressive Pathology Using Guttering Osteotomy During Anterior Cervical Discectomy and Fusion

Removal of Retro-Corporeal Compressive Pathology Using Guttering Osteotomy During Anterior Cervical Discectomy and Fusion

Smoking Does Not Negatively Impact Outcomes Following Cervical Laminoplasty

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