Results of Skip Laminectomy—Minimum 2-Year Follow-up Study Compared With Open-Door Laminoplasty

Shiraishi, Tateru; Fukuda, Kentaro; Yato, Yoshiyuki; Nakamura, Mitsukazu; Ikegami, Takeshi

doi:10.1097/01.brs.0000103340.78418.b2

Cited by 174 publications

(113 citation statements)

References 20 publications

(19 reference statements)

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“…1). This is in remarkable contrast to previously reported results of posterior procedures, which showed a decrease of up to 60% in posterior muscles after surgery [12,13]. Although neck pain was observed in 25.8% of the ACDF patients at followup, no significant association was observed between neck pain and changes in the cross-sectional area of the posterior muscles over time.…”

Section: Discussioncontrasting

confidence: 98%

“…However, ACDF may potentially affect the posterior muscles due to a loss of motion at fused segments. Although there have been several cross-sectional studies on posterior muscles in healthy subjects [2], patients undergoing posterior surgery [12,13], and those suffering from whiplash injury [3], no study to date has examined the long-term changes in posterior muscles after ACDF.…”

Section: Introductionmentioning

confidence: 99%

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Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI

Matsumoto

Okada²,

Ichihara³

et al. 2011

Eur Spine J

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Purpose To evaluate changes in the transverse area of deep posterior muscles of the cervical spine 10 years after anterior cervical decompression and fusion (ACDF), in comparison with healthy volunteers. Methods Thirty-one patients (22 males, 9 females, mean age at follow-up 59.3 years, mean follow-up 12.1 years) who had undergone preoperative MRI and non-instrumented ACDF within levels C3-4 to C5-6 were enrolled. 32 asymptomatic volunteers (17 males, 15 females; mean age, 54.7 years; mean follow-up, 11.7 years) who underwent MRI between 1993 and 1996 served as controls. Follow-up MRI was performed on both patients and control subjects, and the cross-sectional areas of deep posterior muscles were measured digitally at levels C3-4, 4-5, and 5-6. Results The mean total cross-sectional area in the ACDF and control groups was 4,693.6 ± 1,140.9 and 4,825.8 ± 1,048.2 mm 2 in the first MR study (P = 0.63), and 4,616.7 ± 1,086.0 and 5,036.7 ± 1,105.6 mm 2 at followup (P = 0.13). The total cross-sectional area in the ACDF group slightly decreased, while that in the control group increased (-77.1 ± 889.7 vs. 210.9 ± 622.0 mm 2 , P = 0.14). The mean change in the cross-sectional area had no significant correlation with clinical symptoms, including neck pain or JOA score. Conclusions ACDF patients did not show a marked decrease in the cross-sectional area of the deep posterior cervical muscles, but as compared with control subjects there was a slight decrease. A decrease in the cross-sectional area of these muscles after ACDF may not result in the axial symptoms as seen in patients treated by posterior surgery.

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Section: Discussioncontrasting

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI

Matsumoto

Okada²,

Ichihara³

et al. 2011

Eur Spine J

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“…Thirteen studies compared surgical approaches to determine which approach would significantly reduce the incidence or severity of axial pain ( Table 2). The results of 8 of these 13 studies [7,17,22,31,[40][41][42]44] suggested that modified laminoplasty produced less axial pain than conventional laminoplasty. Modified laminoplasty included less invasive surgery and reconstructive technique.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Only one study [30] with regard to the duration of cervical orthosis after cervical laminoplasty showed no difference between the axial pain and no axial pain group (Table 1). The duration of external immobilization, which may be related to postoperative axial pain, was significantly recorded in 3 of 12 comparative studies [17,23,40] (Table 2).…”

Section: Postoperative Managementmentioning

confidence: 99%

“…There were no significant differences between postoperative axial pain and A-P canal diameter [47], preoperative instability [20] or lamina closure [26], but the number of fused laminae [19] was significantly related to postoperative axial pain. Three of 12 comparative studies [22,40,41] showed the correspondence between atrophy rate and incidence or severity of axial pain ( Table 2), suggesting that posterior muscle atrophy may be related to postoperative axial pain.…”

Section: Radiological Assessmentmentioning

confidence: 99%

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Axial pain after posterior cervical spine surgery: a systematic review

et al. 2010

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Posterior operative approach has been the standard treatment for cervical compressive myelopathy, and axial pain after laminoplasty or laminectomy as a postoperative complication is now gradually receiving more and more attention. The objective of this study was to provide a systematic review of the current understanding of axial pain after cervical laminoplasty and laminectomy, and summarize clinical features, influence factors and preventive measures of axial pain after posterior decompressive surgery based on a review of literature published in the English language. Axial pain distributes over nuchal, periscapular and shoulder regions. Posterior surgery is not the major cause of axial pain, but axial pain can be worsened by the procedure. There are many clinical factors that influence postoperative axial pain such as age, preoperative axial pain, different surgical technique and postoperative management, but most of them are still controversial. Several surgical modifications have been innovated to reduce axial pain. Less invasive surgery, reconstruction of the extensor musculature, avoiding detachment of the semispinalis cervicis muscle and early removal of external immobilization have proved to be effective. Axial pain is under the influence of multiple factors, so comprehensive methods are required to reduce and avoid the postoperative axial pain. Because of methodological shortcomings in publications included in this systematic review, different results from different studies may be produced due to differences in study design, evaluation criteria, sample size, and incidence or severity of axial pain. More high-quality studies are necessary for drawing more reliable and convincing conclusions.

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Posterior surgical approach procedures for cervical myelopathy

Pohl¹,

Tamaoki

Rodrigues³

et al. 2015

Cochrane Database of Systematic Reviews

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Part of the Orthopedics Commons This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in Department of Orthopaedic Surgery Faculty Papers by an authorized administrator of the Jefferson Digital Commons.

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Results of Skip Laminectomy—Minimum 2-Year Follow-up Study Compared With Open-Door Laminoplasty

Cited by 174 publications

References 20 publications

Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI

Changes in the cross-sectional area of deep posterior extensor muscles of the cervical spine after anterior decompression and fusion: 10-year follow-up study using MRI

Axial pain after posterior cervical spine surgery: a systematic review

Posterior surgical approach procedures for cervical myelopathy

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