Cervical Spondylotic Myelopathy: Functional and Radiographic Long-term Outcome after Laminectomy and Posterior Fusion

Kumar, Vijay; Rea, Gary L.; Mervis, Lawrence J.; McGregor, John M.

doi:10.1097/00006123-199904000-00046

Cited by 188 publications

(69 citation statements)

References 35 publications

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“…8) In fact, postoperative MR imaging of this technique demonstrated kyphotic change. Therefore, simple laminectomy and posterior fusion is not indicated in cases like ours.…”

Section: Discussionmentioning

confidence: 90%

“…Since the laminoplasty method is popular in Japan, 7,9,10,12,14) we think that there is no reason not to combine plate fixation and laminoplasty with multilevel iliac bone graft rather than laminectomy and plate fixation. 1,8) This combined technique may save an additional anterior approach operation for stabilization or correction of the kyphosis.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5]8,11) We employed the posterior lateral mass plate, which allows immediate and excellent fixation at the facet joint. In addition, the plates are secured bilaterally at the locus of movement, and the rotational stability after plating seems superior to that of interspinous wiring techniques.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,10,12,14) However, laminectomy may result in postoperative instability with associated deformities and delayed neurological deterioration. 6,8,13) Laminoplasty is widely used for achieving spinal canal expansion but also prevents posterior scar formation and postoperative kyphosis or straightening. 7,9,10,12,14) We have been employing the modified Kurokawa's method of laminoplasty 9) in patients with long segment cervical spondylotic myelopathy.…”

Section: Introductionmentioning

confidence: 99%

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Combined Laminoplasty With Posterior Lateral Mass Plate for Unstable Spondylotic Cervical Canal Stenosis-Technical Note-

Matsumura

Yanaka

Akutsu

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A technique of combined expanding laminoplasty using longitudinal interspinous iliac bone graft with posterior lateral mass plate is described for the treatment of cervical canal stenosis associated with spinal instability. A 52-year-old male and a 76-year-old female presented with cervical myelopathy. Imaging studies demonstrated spondylotic cervical canal stenosis associated with spinal instability. Posterior stabilization with lateral mass plate by the Axis Fixation System was performed after expanding laminoplasty using interspinous iliac bone graft. The symptoms improved and instability and malalignment (in the female patient) also improved after surgery. This combined surgical technique allows decompression of the spinal cord, immediate internal fixation by plate fixation, and subsequent long-term stabilization by interspinous bony fusion. This technique is indicated in selected patients with multiple segment spondylotic cervical canal stenosis associated with instability and/or malalignment of the spinal column for which simultaneous decompression and stabilization are required.

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“…8) In fact, postoperative MR imaging of this technique demonstrated kyphotic change. Therefore, simple laminectomy and posterior fusion is not indicated in cases like ours.…”

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Combined Laminoplasty With Posterior Lateral Mass Plate for Unstable Spondylotic Cervical Canal Stenosis-Technical Note-

Matsumura

Yanaka

Akutsu

et al. 2003

Neurol. Med. Chir.(Tokyo)

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“…Decompression via laminectomy is a commonly employed surgical intervention, although many clinicians have reported that the longitudinal results can be less than ideal. Deleterious outcomes associated with laminectomy include development of progressive cervical kyphosis, instability, perineural adhesions and late neurologic deterioration [1,15,16,19,20,24,30,33,34,40]. Laminoplasty eliminates many of these complications and achieves decompression of the spinal cord by allowing the cord to migrate posteriorly away from the compressive lesion, while preserving the posterior bone stock and architecture [22,23].…”

mentioning

confidence: 99%

Biomechanics of cervical laminoplasty: kinetic studies comparing different surgical techniques, temporal effects and the degree of level involvement

Puttlitz

Deviren

Smith

et al. 2004

European Spine Journal

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Laminoplasty is a common surgical technique used to treat cervical myelopathy. Both voids and contradictory information exist in the literature with regard to the initial and long-term biomechanical consequences of cervical laminoplasty. In order to clarify the existing literature, as well as provide clinically useful information, we identified three specific aims: (1) to measure the long-term differences in kinetics between the open door laminoplasty (ODL) and French door laminoplasty (FDL) techniques; (2) to delineate differences in primary and long-term cervical motion after laminoplasty; and (3) to determine whether inclusion of additional levels in the laminoplasty procedure results in a change in immediate cervical biomechanics. The study design involved both an animal (caprine) model and in vitro surgical simulation. We kinematically evaluated the cervical spine specimens (C2-C7) by applying pure bending moment loads to the cephalad vertebra (C2), while constraining the caudal vertebra (C7). Resultant intervertebral rotations (C3-C6) were determined via stereophotogrammetry. Overall, the data indicate that both FDL and ODL significantly reduce range of motion 6 months postoperatively, compared with the un-operated spine. There were no significant differences between the two techniques after 6 months. We also showed that ODL produces a significant reduction in motion 6 months postoperatively compared with the immediate postoperative condition. Finally, the data indicated that extending the laminoplasty from two to four levels did not significantly change range of motion. The choice of technique should be based upon the surgeon's experience with these technically demanding procedures. In addition, initial stability considerations should not affect the decision to extend the laminoplasty to adjacent levels. Finally, the data also suggest that early changes in biomechanics should not be a major factor when considering whether immobilization of the cervical spine is necessary after laminoplasty. In fact, our temporal study, as well as previously reported clinical data, indicates that one should expect significantly decreased intervertebral motion 6 months after laminoplasty. Therefore, early physical therapy should be considered to preserve a more physiologic pattern of cervical range of motion.

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Anterior versus posterior approach for multilevel cervical spondylotic myelopathy

Zhao

Tian

et al. 2016

Cochrane Database of Systematic Reviews

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Cervical Spondylotic Myelopathy: Functional and Radiographic Long-term Outcome after Laminectomy and Posterior Fusion

Cited by 188 publications

References 35 publications

Combined Laminoplasty With Posterior Lateral Mass Plate for Unstable Spondylotic Cervical Canal Stenosis-Technical Note-

Combined Laminoplasty With Posterior Lateral Mass Plate for Unstable Spondylotic Cervical Canal Stenosis-Technical Note-

Biomechanics of cervical laminoplasty: kinetic studies comparing different surgical techniques, temporal effects and the degree of level involvement

Anterior versus posterior approach for multilevel cervical spondylotic myelopathy

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