Open door expansive laminoplasty and postoperative axial symptoms: a comparative study between two different procedures

Sun, Yu; Zhang, Fengshan; Wang, Shaobo; Zhang, Li; Pan, Shengfa; Yu, Miao; Qiu, Sujun

doi:10.1055/s-0030-1267065

Cited by 15 publications

(13 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preservation of the attachments of the nuchal muscles to the spinous process of the axis (the rectus major, inferior oblique, and semispinalis cervicis) and the muscle attachments to the spinous process of C7 (rhomboid and trapezius) protects postoperative cervical lordosis, ROM and decreases axial pain (18). The preservation of the unilateral nuchal, supraspinous and interspinous ligaments between C2-C7 is also important for the maintenance of cervical spinal lordosis and to lower the rate of postoperative axial neck pain (23). Reduced surgical exposure, no detachment of the muscle from the C2 and C7 spinous process and the restriction of the laminoplasty from C3 to C6 reduce postoperative kyphotic changes (2,17).…”

Section: █ Discussionmentioning

confidence: 99%

New laminoplasty technique for preserving paravertebral muscles: technical note

Seçer

Polat²

2018

Turkish Neurosurgery

View full text Add to dashboard Cite

AIM: To develop a new laminoplasty technique for preserving paravertebral muscles. MATERIAL and METHODS: In this technique, semispinalis and splenius muscles are cut approximately 1 cm laterally to the muscle insertion point to the spinous process at the laminotomy side. Then, multifidus and rotatory muscles are dissected subperiosteally and retracted laterally. The posterior part of the spinous process is cut horizontally below the insertion point of the semispinalis and splenius muscles. At this point, all the contralateral paravertebral muscles with the cut head of the spinous process are dissected subperiosteally and retracted laterally in the same manner as the laminotomy side. After the open-door laminoplasty for reconstruction of the anatomical formation, we fixed the head of the spinous process on the opening side laminae close to the inferior part of the spinous process with a titanium wire. RESULTS: This technique is unique in that it reconstructs the spine similar to its normal anatomical form by preserving the posterior paravertebral muscles' attachments to the bones and tension ligaments. CONCLUSION: This technique can reduce the risk of axial pain and kyphotic deformity, and prevent the reduction of ROM.

show abstract

Section: █ Discussionmentioning

confidence: 99%

New laminoplasty technique for preserving paravertebral muscles: technical note

Seçer

Polat²

2018

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…The C7-sparing technique preserved the C7 spinous process and its paraspinal muscular attachment, with only 3% of the patients complaining of post-AS [17], which was in contrast to 70% of patients reporting post-AS [18]. Cervical laminoplasty that can conserve the unilateral posterior muscular-ligament complex may lower the rate of post-AS [19]. In our study, the total incidence of post-AS after the single-door cervical laminoplasty was 40.2%.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Factors Affecting Postoperative Axial Symptoms After Single-Door Cervical Laminoplasty for Cervical Spondylotic Myelopathy: A Prospective Comparative Study

Liu

Zhang

et al. 2016

Med Sci Monit

View full text Add to dashboard Cite

BackgroundPostoperative axial symptoms (post-AS) after single-door cervical laminoplasty for cervical spondylotic myelopathy (CSM) are a common and severe complication that adversely affects normal daily activities. Their etiology remains unclear. It is important to know which preoperative factors are the most predictive of post-AS. Therefore, this study aimed to elucidate the preoperative factors affecting post-AS.Material/MethodsA total of 102 patients with CSM who underwent single-door cervical laminoplasty between 2009 and 2015 were studied. According to operation date, patients were prospectively assigned to treatment with conventional laminoplasty (CL) or modified laminoplasty (ML). Preoperative clinical and radiological parameters were recorded. The incidence of post-AS with 2 procedures was compared prospectively. Multivariate analysis was used to determine the preoperative factors affecting post-AS.ResultsThe incidence of post-AS after ML was significantly lower than after CL (P=0.010). ML and preoperative cervical C2–7 Cobb angle (CCA) were significant protective factors against post-AS (ML: P=0.011, odds ratio=0.302; CCA: P=0.042, odds ratio=0.947). Patients with post-AS had a lower preoperative CCA than patients without post-AS (P=0.043). The other preoperative factors were not significantly associated with post-AS.ConclusionsThe results of this study suggest that choosing ML procedure or selecting patients with high preoperative CCA can reduce the incidence of post-AS after single-door cervical laminoplasty for CSM, and that the other preoperative clinical or radiological parameters are less critical.

show abstract

“…32,87,92,105 Other reports just provided the incidence or percentage of postoperative kyphotic deformity. 4,28,67,107 Only 21 (20%) studies reported statistical comparisons between the preoperative and postoperative C2-7 angles.…”

Section: Postoperative Spinal Alignment and Deformitymentioning

confidence: 99%

“…9,15,41,42,45,46,81,87,97 Emphasis was placed on the semispinalis cervicis, which they tried to preserve 97 or repair. 5,74,110 Furthermore, they also tried to preserve muscles that attach to the spinous processes of C-7.…”

Section: Neck Painmentioning

confidence: 99%

Cervical laminoplasty developments and trends, 2003–2013: a systematic review

Duetzmann¹,

Cole²,

Ratliff³

2015

SPI

View full text Add to dashboard Cite

OBJECT Despite extensive clinical experience with laminoplasty, the efficacy of the procedure and its advantages over laminectomy remain unclear. Specific clinical elements, such as incidence or progression of kyphosis, incidence of axial neck pain, postoperative cervical range of motion, and incidence of postoperative C-5 palsies, are of concern. The authors sought to comprehensively review the laminoplasty literature over the past 10 years while focusing on these clinical elements. METHODS The authors conducted a literature search of articles in the Medline database published between 2003 and 2013, in which the terms “laminoplasty,” “laminectomy,” and “posterior cervical spine procedures” were used as key words. Included was every single case series in which patient outcomes after a laminoplasty procedure were reported. Excluded were studies that did not report on at least one of the above-mentioned items. RESULTS A total of 103 studies, the results of which contained at least 1 of the prespecified outcome variables, were identified. These studies reported 130 patient groups comprising 8949 patients. There were 3 prospective randomized studies, 1 prospective nonrandomized alternating study, 15 prospective nonrandomized data collections, and 84 retrospective reviews. The review revealed a trend for the use of miniplates or hydroxyapatite spacers on the open side in Hirabayashi-type laminoplasty or on the open side in a Kurokawa-type laminoplasty. Japanese Orthopaedic Association (JOA) scoring was reported most commonly; in the 4949 patients for whom a JOA score was reported, there was improvement from a mean (± SD) score of 9.91 (± 1.65) to a score of 13.68 (± 1.05) after a mean follow-up of 44.18 months (± 35.1 months). The mean preoperative and postoperative C2–7 angles (available for 2470 patients) remained stable from 14.17° (± 0.19°) to 13.98° (± 0.19°) of lordosis (average follow-up 39 months). The authors found significantly decreased kyphosis when muscle/posterior element–sparing techniques were used (p = 0.02). The use of hardware in the form of hydroxyapatite spacers or miniplates did not influence the progression of deformity (p = 0.889). An overall mean (calculated from 2390 patients) of 47.3% loss of range of motion was reported. For the studies that used a visual analog scale score (totaling 986 patients), the mean (cohort size–adjusted) postoperative pain level at a mean follow-up of 29 months was 2.78. For the studies that used percentages of patients who complained of postoperative axial neck pain (totaling 1249 patients), the mean patient number–adjusted percentage was 30% at a mean follow-up of 51 months. The authors found that 16% of the studies that were published in the last 10 years reported a C-5 palsy rate of more than 10% (534 patients), 41% of the studies reported a rate of 5%–10% (n = 1006), 23% of the studies reported a rate of 1%–5% (n = 857), and 12.5% reported a rate of 0% (n = 168). CONCLUSIONS Laminoplasty remains a valid option for decompression of the spinal cord. An understanding of the importance of the muscle-ligament complex, plus the introduction of hardware, has led to progress in this type of surgery. Reporting of outcome metrics remains variable, which makes comparisons among the techniques difficult.

show abstract

Open door expansive laminoplasty and postoperative axial symptoms: a comparative study between two different procedures

Cited by 15 publications

References 8 publications

New laminoplasty technique for preserving paravertebral muscles: technical note

New laminoplasty technique for preserving paravertebral muscles: technical note

Preoperative Factors Affecting Postoperative Axial Symptoms After Single-Door Cervical Laminoplasty for Cervical Spondylotic Myelopathy: A Prospective Comparative Study

Cervical laminoplasty developments and trends, 2003–2013: a systematic review

Contact Info

Product

Resources

About