Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy

Gargiulo, G.; Girardo, Massimo; Rava, Alessandro; Coniglio, A.; Cinnella, Pasquale; Massè, Alessandro; Fusini, Federico

doi:10.1007/s00590-019-02395-6

Cited by 20 publications

(10 citation statements)

References 44 publications

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“…The spine surgeon usually divides the muscles with the exception of the platysma and the omohyoid, which can be transected, and the longus colli that normally are detached from the anterior surface of the cervical spine. In posterior approaches, the posterior paraspinal muscles are detached from the spine in order to gain access to underlying significant anatomical structures such as the spinous process, the laminae, the facets, the pedicles, the neuronal foramens, the vertebrae, the spinal canal and the spinal cord [36][37][38][39][40][41][42][43][44]. The degree of detachment depends on the pathology and the type of the procedure (laminectomy/laminectomies, foraminotomies, posterior fusion with screws and rods, etc).…”

Section: Discussionmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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Cervical spine musculature still remains a less studied component of the cervical spine anatomical compartments, although it plays a significant role in the mobility of the head and the preservation of cervical spine alignment. The goal of this study was to extract any significant information from the literature regarding the role of cervical spine muscles morphology in the outcome of surgically treated patients for degenerative disc disease (DDD) based on preoperative magnetic resonance imaging (MRI) studies. Eleven clinical case series were found, from which four were prospective and seven were retrospective. Six studies were concentrated on anterior approaches and five studies on posterior approaches in the cervical spine. In posterior approaches aiming at the preservation of muscles attachments and overall less surgical manipulations, results on cervical lordosis, axial pain and patient's functionality were found superior to traditional laminectomies. The study of cross-sectional areas (CSAs) of deep paraspinal muscles in the cervical spine could add significant information for the spine surgeon such as the prediction of adjacent level disease (ALD), fusion failure, axial pain persistence, postoperative cervical alignment and patient's postoperative functionality. It seems that MRI studies focusing on muscle layers of the cervical spine could add significant information for the spinal surgeon regarding the final surgical outcome in terms of pain and function expres-sion. Larger multicenter clinical studies are a necessity in defining the role of the muscle component of the cervical spine in the surgical treatment of DDD.

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Section: Discussionmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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“…Surgical treatment for osteoporotic vertebral fracture (OVF) is still challeng-ing for spine surgeons. The literature reports several approaches to treatment, but there is no current consensus on a standard technique [3][4][5][6][7]. Compared with younger population, high rate of complications is associated with pedicle screw fixation because of poor bone quality such as loosening, pullout, or screw migration [8].…”

Section: Introductionmentioning

confidence: 99%

Long versus Short Segment Instrumentation in Osteoporotic Thoracolumbar Vertebral Fracture

et al. 2021

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This study aimed to compare clinical and radiological data and rate of mechanical complications in elderly patients treated with short segment (SSS) or long segment stabilization (LSS) for thoracolumbar junction osteoporotic vertebral fractures (OVFs). Overview of Literature: A fervent debate is now focused on the treatment of OVF using SSS or LSS. High rate of complications is associated with pedicle screw fixation because of poor bone quality. Methods: Patients over 65 years old with a T-score of <−2.5, affected by (T10-L2) vertebral fracture treated with LSS or SSS pedicle screw fixation, with at least 24 months of follow-up were evaluated. All patients were analyzed with conventional X-ray to evaluate bisegmental kyphotic angle (BKA) and clinically with Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and rate of mechanical complications at 2, 6, 12, and 24 months. Data were expressed as mean±standard deviation. Student t-test was used to compare clinical scores between populations. Mann-Whitney U-test was used to analyze clinical and radiological variable, whereas Fisher's exact test was used to identify differences in the rate of complications between groups. Results: A total of 37 patients met the inclusion criteria. Mean follow-up was 33.97±9.26 months. For both groups, ODI and VAS significantly decreased over time with good results (p<0.00001). At the final follow-up, no significant differences were found in terms of ODI and VAS. There was no difference in correction of BKA between groups; however, a significant difference was found in LSS group between pre-and postoperative BKA (p=0.046), whereas no difference was found in SSS group. A significant difference in the rate of mechanical complications was found between groups (p=0.011). Conclusions: Both treatments showed good clinical and radiological results; however, LSS group showed better BKA correction and lower mechanical complications than SSS group.

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“…Complications were extremely rare in both arms of the study with the same rate of other studies that show how the posterior approach is safer for the patient. [24252627282930] Clinical results were also satisfactory [Figures 1 and 2]. The scores obtained with the administration of the SRS 24 questionnaire (which has been used for years in studies published in the literature)[3132] were comparable in the two study-arms.…”

Section: Discussionmentioning

confidence: 77%

Over 70° thoracic idiopathic scoliosis: Results with screws or hybrid constructs

Cinnella

Rava

Mahagna

et al. 2019

J Craniovert Jun Spine

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Background: Adolescent idiopathic scoliosis is the most common type of scoliosis. High degrees curve can be treated with the anterior, posterior, or combined anterior–posterior approach. Contrarily to the anterior approach, the posterior one is widely used nowadays for its good correction outcomes and relatively low-complication rate. Materials and Methods: We evaluated retrospectively 27 patients, treated with posterior approach. Patients were divided into two groups, namely pedicle screws group (PSG) and hybrid group (pedicle screws + sublaminar bands). Radiographic measurements, including thoracic and lumbar Cobb° measurements of primary and secondary curves, coronal balance and sagittal balance, kyphosis and lordosis, curve flexibility, first and last vertebra included in the arthrodesis, and implant density were evaluated. Clinical patients' satisfaction was also evaluated with Scoliosis Research Society (SRS) 24 questionnaire. Results: Considering both groups, on preoperative X-rays, the average primary scoliotic curve angle was 83.56° ± 10.96° (range 70°–112°), whereas the global flexibility was 64° ± 7.63 (range 46°–72°). The curves were classified following the Lenke classification: 17 Type 1, 2 Type 2, and 8 Type 3. The primary curve resulted to be well corrected in both groups. In T0, the groups were homogeneous, but in T1 and follow-up, PSG stated a better mean value. No other significative differences can be found between groups for all other items ( P > 0.05). Clinical results of SRS 24 were excellent in both groups. Conclusions: The posterior approach proved to be an excellent technique for obtaining good clinical and radiographic results if the surgeon adopts the third-generation high-density implants. Level of Evidence: III.

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Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy

Cited by 20 publications

References 44 publications

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

Long versus Short Segment Instrumentation in Osteoporotic Thoracolumbar Vertebral Fracture

Over 70° thoracic idiopathic scoliosis: Results with screws or hybrid constructs

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