Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy

Bakr, Oussama; Soufi, Khadija; Jones, Quincy; Bautista, B Fernández; Van, Benjamin W.; Boozé, Zachary L; Martín, Allan; Klineberg, Eric O.; Le, Hai; Ebinu, Julius O.; Kim, Kee D.; Javidan, Yashar; Roberto, Rolando Figueroa

doi:10.1016/j.xnsj.2023.100232

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…However, more recent evidence has shown that stenosis may be an even more important factor in the cause of myelopathy compared with instability. This is seen in the laminoplasty versus posterior instrumented fusion population, where laminoplasty—a motion-preserving procedure—has yielded comparable results to fusion, while having lower rates of cost and complication 28 . Similar reasoning can be applied to the anterior cervical approach, where removing the compressive pathology and preserving motion, as seen with CDA, may be efficacious in treating myelopathy without requiring arthrodesis.…”

Section: Discussionmentioning

confidence: 87%

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Is Cervical Disk Arthroplasty a Suitable Alternative to Treat Degenerative Cervical Myelopathy?

Schupper,

Boylan,

Houten

2023

Clinical Spine Surgery: A Spine Publication

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Study Design: Systemic review Objective: To understand the role of cervical disk arthroplasty in the treatment of cervical myelopathy. Summary of Background Data: The surgical management of degenerative cervical myelopathy (DCM) most frequently involves decompression and fusion, but stiffness introduced by the fusion and adjacent segment degeneration remain problems that can result in significant morbidity. Cervical disk arthroplasty (CDA) is a newer procedure that has been demonstrated to be safe and effective for the management of cervical spine degenerative disk disease, but it has not been traditionally considered as a treatment option for DCM and the use for this indication has not been extensively studied. Materials and Methods: A systematic review was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using a search strategy to query all relevant articles on the use of cervical disk arthroplasty in the setting of cervical myelopathy over a 20-year period (2004–2023). This review examines the literature to assess our current understanding of the appropriateness, safety, and value of CDA in the treatment of DCM. Results: A total of 844 patients received CDA across the 14 studies that met inclusion criteria, with an average of 60.3±40.4 patients per study (range: 11–152 subjects). Featured studies included 5 (35.7%) prospective studies, of which 2 were randomized. All studies had primary outcome measures of disability and/or pain scores, with the Japanese Orthopedic Association myelopathy score and neck disability index as the most commonly assessed. Four (26.7%) studies compared arthroplasty with arthrodesis. Safety of CDA for DCM was found in all studies with improvement in clinical outcome measurements. Conclusion: Cervical disk arthroplasty appears to be a safe and effective surgical option in the management of degenerative cervical myelopathy. Further study is needed to assess if arthroplasty provides clinical improvement in DCM of comparable magnitude and durability as traditional fusion strategies.

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Section: Discussionmentioning

confidence: 87%

“…Since the full FDA approval of the stainless-steel Prestige device in 2007, a wealth of high-quality clinical data on CDA has accumulated that attest to the safety and effectiveness of CDA as compared with ACDF 21,28,29 . Indeed, CDA is featured in over 950 clinical studies published over the past 20 years, with ~40% from US centers.…”

Section: Discussionmentioning

confidence: 99%

Is Cervical Disk Arthroplasty a Suitable Alternative to Treat Degenerative Cervical Myelopathy?

Schupper,

Boylan,

Houten

2023

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

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A comparison of clinical and radiological outcomes following laminectomy and laminectomy with fusion in patients of cervical spondylotic myelopathy: A systematic review and meta-analysis

Reddy,

Satapathy,

Raja

et al. 2024

Neurosurg Rev

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Effects of two posterior procedures for treatment of cervical hyperextension injury with multilevel spinal stenosis: A retrospective study

Liang,

Guo,

et al. 2024

Preprint

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Background Cervical hyperextension injuries (CHI), commonly resulting in central cord syndrome and spinal instability, often affect the elderly with preexisting degenerative spinal changes, leading to a need for surgical interventions that address both the compression and stability of the cervical spine. This study compares the clinical outcomes of two posterior decompression and fixation procedures for treating cervical hyperextension injury in patients with preexisting multilevel spinal canal stenosis.Methods Patients suffering from cervical hyperextension injury combined with multilevel spinal stenosis were divided into two groups. They received laminoplasty combined with selective unilateral pedicle screw fixation or laminectomy combined with bilateral lateral mass screw fixation. The clinical records including demographic data, operation time, length of hospital stay, estimated blood loss and surgical complications were collected, and clinical outcomes were evaluated using the American Spinal Injury Association (ASIA) impairment scale. Preoperative and postoperative cervical lordosis were measured.Results Postoperative AISA scores were significantly increased compared with that before surgery in both groups, there was no significant differences between groups. The intraoperative blood loss in the laminoplasty group was significantly less than that in the laminectomy group and there were no significant differences in operation time and length of hospital stay between the two groups. No significant difference was found in the incidence of overall surgical complications between the two groups. There was no significant difference in the cervical lordosis after surgery compared with that before surgery in both groups.Conclusions For patients suffering from cervical hyperextension injury combined with preexisting multilevel spinal stenosis, both cervical laminoplasty with selective unilateral pedicle screw fixation and laminectomy with bilateral lateral mass screw fixation could achieve satisfactory clinical outcomes.

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Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy

Cited by 3 publications

References 24 publications

Is Cervical Disk Arthroplasty a Suitable Alternative to Treat Degenerative Cervical Myelopathy?

Is Cervical Disk Arthroplasty a Suitable Alternative to Treat Degenerative Cervical Myelopathy?

A comparison of clinical and radiological outcomes following laminectomy and laminectomy with fusion in patients of cervical spondylotic myelopathy: A systematic review and meta-analysis

Effects of two posterior procedures for treatment of cervical hyperextension injury with multilevel spinal stenosis: A retrospective study

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