Comparison of Anterior Decompression and Fusion With Posterior Laminoplasty for Multilevel Cervical Compressive Myelopathy

Jiang, Lianghai; Tan, Mingsheng; Dong, Liang; Yang, Feng; Yi, Ping; Tang, Xiuwen; Hao, Qingying

doi:10.1097/bsd.0000000000000317

Cited by 41 publications

(24 citation statements)

References 17 publications

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“…Laminoplasty and laminectomy followed by fusion are 2 of the most commonly performed posterior procedures for the treatment of multilevel cervical compressive myelopathy. [ 5 – 8 ] Several articles have previously addressed decision making in the treatment of multilevel cervical compressive myelopathy. Yoon et al [ 1 ] conducted a systematic review comparing laminoplasty and laminectomy followed by fusion, but could not give pooled data.…”

Section: Discussionmentioning

confidence: 99%

MRI features of testicular spermatic granuloma

Liu

Yang²,

Huo³

et al. 2022

Medicine

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This is a meta-analysis to compare the results between laminoplasty and laminectomy followed by fusion for the patients with multilevel cervical compressive myelopathy. An extensive search of literature was performed in MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG. The following outcome measures were extracted: the Japanese Orthopaedic Association (JOA) scores, cervical curvature index (CCI), visual analog scale (VAS), cervical lordosis (C2–7), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3 and STATA 12.0. A total of 23 studies comprising 774 and 743 patients treated with laminoplasty and laminectomy followed by fusion, respectively, were included in the final analysis. The pooled analysis showed that there was no significant difference in preoperative JOA scores [P = 0.89], postoperative JOA scores [P = 0.13], JOA scores improvement rate [P = 0.27], preoperative CCI [P = 0.15], postoperative CCI [P = 0.14], preoperative VAS [P = 0.41], postoperative VAS [P = 0.52], preoperative cervical lordosis (C2–7) [P = 0.46], postoperative cervical lordosis (C2–7) [P = 0.67], total complications [P = 0.07], axial pain [P = 0.94], and blood loss [P = 0.51]. However, there were significant difference in operation time (WMD = −19.57 [−32.11, −7.02], P = 0.002) and C5 palsy (OR = 0.26 [0.15, 0.44], P < 0.001). As compared with laminectomy followed by fusion, expansive laminoplasty showed no significant differences in JOA scores, CCI, ROM, VAS, cervical lordosis (C2–7), axial pain, total complications, and blood loss, but shorter operation time and fewer C5 palsy.

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Section: Discussionmentioning

confidence: 99%

MRI features of testicular spermatic granuloma

Liu

Yang²,

Huo³

et al. 2022

Medicine

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“…Anterior cervical discectomy and fusion (ACDF) is one of the most common spinal surgeries 10 , which can be used to correct cervical kyphosis and improve the symptoms of nerve root and spinal cord compression. Changes in cervical alignment before and after surgery have a direct impact on health-related quality of life (HRQOL) 11 .…”

Section: Discussionmentioning

confidence: 99%

Improvement of sagittal parameters in patients with cervical spondylotic myelopathy is associated with outcome after anterior cervical discectomy and fusion

Liu

Wang

et al. 2020

Preprint

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Purpose: After ACDF, cervical lordosis loss, high C2-7 SVA and postoperative T1S will worsen the surgical prognosis. Therefore, this study evaluated the changes of cervical parameters after surgery and correlation with surgical prognosis. Methods: This study enrolled 212 cervical compressive myelopathy patients who underwent ACDF. We collect gender, age, BMI, NDI scores and cervical parameters. And then, we compare the changes of parameters after surgery, and explore the correlation between parameters and NDI score. Results: C2-7 Cobb Angle, SVA, T1S and TS-CL were all improved after surgery, but T1S at the last follow-up was larger than that before the surgery. T1S is positively correlated with TIA (p=0.018, r=0.081), CL (p<0.01, r=0.150) and SVA (p<0.01, r=0.131), but negatively correlated with SCA (p<0.01, r=-0.166). We also found that TIA was highly correlated with the sum of T1S+NT (p<0.01, r=0.459). Preoperative NDI was negatively correlated with preoperative c2-7 Cobb Angle (r=-0.147, p=0.033), positively correlated with SVA (r=0.157, p=0.022). The last follow-up NDI score was negatively correlated with C2-7 Cobb Angle (r=-0.222 p=0.001), positively correlated with SVA (r=0.498, p<0.001) and TS-CL (r=0.165, p=0.016). The risk factors with poor follow-up NDI score (the last follow-up NDI score greater than 30%) were SVA (B=0.337, P=<0.001), CL (B=-0.147, P=0.029) and gender (B=2.153, P=0.017). Conclusions: After ACDF, most postoperative cervical parameters have improved, but T1S deteriorated over time. There was a close correlation between cervical sagittal parameters. Preoperative NDI score was correlated with c2-7 Cobb Angle and SVA. Follow-up NDI score was correlated with CL, TS-CL and SVA. High SVA, loss of cervical lordosis and male patient were risk factors for the deterioration of postoperative NDI score.

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“…This surgical method may not be effective for spinal cord decompression when the main pathology is behind the vertebral bodies, consequently, complete neurological recovery fails [23][24][25]. Therefore appropriate case selection is centerpiece factor in achievement of this procedure and neurological recovery.…”

Section: Discussionmentioning

confidence: 99%

Anterior cervical discectomy and fusion solely with peek cages in multilevel cervical spondylotic radiculomyelopathy: single center clinical experience with 58 consecutive patients

Şimşek¹

2017

Med-Science

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Aim of this study was to evaluate the efficacy and safety of fusion solely with polyetheretherketone (PEEK) cages without plates and autogenous bone graft to provide fusion in multilevel cervical spondylosis in selected cases. 58 patients with cervical discogenic disorders in 3-4 levels (38 and 20 patients respectively) underwent multilevel anterior cervical discectomy and fusion (ACDF) operations with PEEK cages for a total of 194 levels. Minimum follow up was 24 months (24-48) postoperatively. Outcome had been established in combination with the evaluation of cervical lordosis, fusion rates and neurological improvement that was assessed by Japanese Orthopedic Association (JOA) scoring system. They were assessed by radiographs, computerized tomography and magnetic resonance imaging studies. Clinical outcomes were based on the issues including length of hospital stay, blood loss, complication rates and functional outcomes. 38 patients underwent three-level, 20 patients underwent four-level operations. Fusion rate was 89.2%. Significant improvement in the JOA scores was recorded postoperatively, and Ishihara Curvature Index (ICI) was preserved. In the follow-up period, no cage migration was experienced and reoperation was not required except for one who later underwent corpectomy and anterior fusion. ACDF with the use of PEEK cages without plates proved to yield good clinical outcome and comfortable postoperative course for the patients with acceptable fusion rates.

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Comparison of Anterior Decompression and Fusion With Posterior Laminoplasty for Multilevel Cervical Compressive Myelopathy

Cited by 41 publications

References 17 publications

MRI features of testicular spermatic granuloma

MRI features of testicular spermatic granuloma

Improvement of sagittal parameters in patients with cervical spondylotic myelopathy is associated with outcome after anterior cervical discectomy and fusion

Anterior cervical discectomy and fusion solely with peek cages in multilevel cervical spondylotic radiculomyelopathy: single center clinical experience with 58 consecutive patients

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