Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients

Abstract

The objective of the study was to investigate the comorbidity of degenerative spondylolisthesis (DS), in elderly cervical spondylotic myelopathy (CSM) patients in our hospital, and the correlation between surgical results and preoperative DS. There are few studies on the outcome of laminoplasty for CSM with DS. A total of 49 elderly patients ([65 years old) who eventually had surgical treatment for CSM were evaluated. A slippage displacement of more than 2.5 mm at least at one level was classified to have a positive DS on flexion/extension radiographs (DS group). A slippage displacement less than 1.0 mm was considered a negative DS (non-DS group). Seventeen patients who had slippage of 1.0-2.5 mm were excluded from the study. The DS group (n = 15) included cases with DS at preoperation, while the remaining cases (n = 17) belonged to the non-DS group. The flexion/ extension radiographs of the two groups were compared for range of motion and clinical results at 3 years after the operation. Of all elderly patients, 30.6% had DS. There was no significant difference between the two groups based on the clinical results. The range of motion of all cervical spines (DS group and non-DS group) was significantly limited. However, there was no significant difference between the two groups. New postoperative DS appeared in four patients, of which two were from the DS group and two from the non-DS group. These data suggest that degenerative spondylolisthesis does not influence surgical results in elderly cervical spondylotic myelopathy patients.

Degenerative cervical spondylolisthesis: a systematic review

“…Of 123 patients, 57 patients (46.3%) were found to be unstable using flexion-extension views in five studies [5,6,8,9,11]. In the other study, Dean et al [10] reported 17 unstable levels (23.6%) of the 72 levels in 58 patients with degenerative cervical spondylolisthesis.…”

“…1) [5][6][7][8][9][10][11]. Degenerative cervical spondylolisthesis was most common in C3/4 and C4/5, occurring in 81 patients at C3/4 (46%) and 87 at C4/5 (49.4%).…”

“…After screening the abstracts, eight articles underwent further analysis [4][5][6][7][8][9][10][11]. The detailed data are listed in Table 1.…”

“…However, the criteria for the diagnosis of instability in these studies were not identical ( Table 2). Magnetic resonance imaging (MRI) was used to determine the location and extent of neurological compression at the level of spondylolisthesis in seven studies [5][6][7][8][9][10][11].…”

In vivo 3D kinematic changes in the cervical spine after laminoplasty for cervical spondylotic myelopathy

“…5, 7, and 8). Shigematsu et al 23 reported that 87% of cervical degenerative spondylolisthesis had stabilized after laminoplasty, and Kawasaki et al 14 reported that in 93% of cases, degenerative spondylolisthesis occurred at C3-4 or C4-5. Given our results, we believe that cervical laminoplasty preserves cervical ROM without harmful intervertebral instability and is a reasonable and beneficial procedure for the treatment of elderly patients with myelopathy who have degenerative spondylolisthesis of the middle cervical spine.…”