Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging

Yusof, Mohd Imran; Hassan, Eskandar; Abdullah, Syed Mohamad Syed

doi:10.1007/s00276-010-0704-7

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…Indirect decompression of the anterior aspect of the spinal cord is achieved by posterior drift of the spinal cord. 17,18 It was previously believed that whether a sufficient expansion of the spinal canal with an effective spinal cord drift is achieved would directly affect the outcome of these posterior treatments. 19 In previous studies, the extent of decompression by laminoplasty or laminectomy and fusion has not been compared effectively due to the lack of a measurement available.…”

Section: Discussionmentioning

confidence: 99%

Modified Plate-only Open-door Laminoplasty Versus Laminectomy and Fusion for the Treatment of Cervical Stenotic Myelopathy

Yang

Gu²,

Shi³

et al. 2013

Orthopedics

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The purpose of this study was to compare modified plate-only laminoplasty and laminectomy and fusion to confirm which of the 2 surgical modalities could achieve a better decompression outcome and whether a significant difference was found in postoperative complications. Clinical data were retrospectively reviewed for 141 patients with cervical stenotic myelopathy who underwent plate-only laminoplasty and laminectomy and fusion between November 2007 and June 2010. The extent of decompression was assessed by measuring the cross-sectional area of the dural sac and the distance of spinal cord drift at the 3 most narrowed levels on T2-weighted magnetic resonance imaging. Clinical outcomes and complications were also recorded and compared. Significant enlargement of the dural sac area and spinal cord drift was achieved and well maintained in both groups, but the extent of decompression was greater in patients who underwent laminectomy and fusion; however, a greater decompression did not seem to produce a better clinical outcome. No significant difference was observed in Japanese Orthopaedic Association and Nurick scores between the 2 groups. Patients who underwent plate-only laminoplasty showed a better improvement in Neck Dysfunction Index and visual analog scale scores. In addition, limited decompression, rigid reconstruction of the spinal canal, and preservation of cervical mobility combined with preservation of the posterior structure resulted in a lower rate of postoperative C5 palsy and axial pain in the modified laminoplasty group. For this reason, modified laminoplasty may be a more viable option for patients with cervical stenotic myelopathy.

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Section: Discussionmentioning

confidence: 99%

Modified Plate-only Open-door Laminoplasty Versus Laminectomy and Fusion for the Treatment of Cervical Stenotic Myelopathy

Yang

Gu²,

Shi³

et al. 2013

Orthopedics

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“…This anatomical variance can be determined precisely and accurate instrumental sizing can then be determined and develop to comply with the limitations [1,6]. In addition, it may also help in predicting the outcomes of the new procedure [26]. Even though a cadaveric study gives more actual operative setting, it can be limited due to its availability and strict ethical procedure.…”

Section: Discussionmentioning

confidence: 99%

Translaminar screw fixation of the cervical spine in Asian population: feasibility and safety consideration based on computerized tomographic measurements

Yusof

Shamsi

2011

Surg Radiol Anat

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“…Several authors measured the spinal cord shift after expansive laminoplasty. Yusof et al 26 reported that the difference in the space anterior to the cord between before and after expansive laminoplasty ranged from 8.6 to 10.9 mm. Sodeyama et al 27 reported that the spinal cord shift ranged from 0 to 6.6 mm, whereas Kong et al 28 reported that the peak anterior subarachnoid space was 6.9 mm in patients undergoing expansive laminoplasty from C3 to C7.…”

Section: E498mentioning

confidence: 99%

Influence of Spinous Process Spacers on Surgical Outcome of Laminoplasty for OPLL

Nagashima¹,

Nanjo²,

Tanida³

et al. 2013

Orthopedics

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Expansive laminoplasty for ossification of the posterior longitudinal ligament (OPLL) has had favorable outcomes. Many modifications of expansive laminoplasty have been developed, including expansive laminoplasty with and without spinous process spacers (SPS). The purpose of this study was to determine whether surgical outcomes were similar between expansive laminoplasty surgeries with and without SPS.Of 109 consecutive patients undergoing surgery for OPLL, 68 patients undergoing expansive laminoplasty were included in the study after excluding patients with other conditions affecting their functional status. The patients were divided into 2 groups based on their K-line, which connects the midpoints of the spinal canal at C2 and C7. Patients were further divided into 2 subgroups: those undergoing expansive laminoplasty without SPS (without SPS group) and those undergoing expansive laminoplasty with SPS (with SPS group). Surgical outcomes were evaluated between K-line (+) and K-line (-) groups. After dividing those groups further into the with SPS and without SPS groups, the differences in surgical outcomes were evaluated again.No significant difference existed in the recovery rate between the with SPS and without SPS groups and between the K-line (+) and K-line (-) groups. When the surgical outcome was only evaluated in the K-line (+) group, the recovery rate 1 year postoperatively was higher in patients without SPS than in those with SPS. Therefore, for patients with K-line (+), the possibility exists that SPS can restrict the posterior shift of the spinal cord and affect the surgical outcome.

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Predicted cervical canal enlargement and effective cord decompression following expansive laminoplasty using cervical magnetic resonance imaging

Abstract: Laminoplasty may produce larger canal expansion at the lower cervical spine compared to the upper cervical area; therefore, the outcomes of those who have predominantly higher cervical myelopathy were inferior to those who have lower cervical myelopathy.

Cited by 13 publications

References 20 publications

Modified Plate-only Open-door Laminoplasty Versus Laminectomy and Fusion for the Treatment of Cervical Stenotic Myelopathy

Modified Plate-only Open-door Laminoplasty Versus Laminectomy and Fusion for the Treatment of Cervical Stenotic Myelopathy

Translaminar screw fixation of the cervical spine in Asian population: feasibility and safety consideration based on computerized tomographic measurements

Influence of Spinous Process Spacers on Surgical Outcome of Laminoplasty for OPLL

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