Effect of double-door laminoplasty on atypical symptoms associated with cervical spondylotic myelopathy/radiculopathy

Abstract

BackgroundDouble-door laminoplasty is an effective method in treating patients with cervical spondylosis. Many patients with cervical spondylosis experience a set of atypical symptoms such as vertigo and tinnitus, and wish to know if the surgical treatment for cervical spondylosis can also alleviate those symptoms. The current research was carried out to investigate if atypical symptoms can be alleviated in patients who received laminoplasty for the treatment of cervical spondylosis.MethodsOne hundred ninety patients who received laminoplasty to treat cervical spondylotic myelopathy/radiculopathy in our center and complained about one or more of the atypical symptoms before the surgery were followed for a mean of 61.9 months (from 39 to 87 months) after the surgery. Severity scores were retrospectively collected by follow up outpatient visits or phone interviews. The data was calculated based on patient feedback on the frequency and severity of those symptoms before the surgery and at last follow up, and were compared by paired sample t-tests.ResultsMost patients reported that the atypical symptoms such as vertigo (P <0.001), nausea (P <0.001), headache (P <0.001), tinnitus (P = 0.001), blur vision (P = 0.005), palpitation (P <0.001) and gastrointestinal discomfort (P = 0.001) were significantly alleviated at the last follow up; there was no significant change in the severity of hypomnesia (P = 0.675).ConclusionDouble-door laminoplasty can significantly alleviate most of the atypical symptoms in patients with cervical spondylosis. Further research is needed to explore mechanisms underlying this extra benefit of laminoplasty.

Preoperative imaging differences of patients with cervical spondylosis with cervical vertigo indicate the prognosis after cervical total disc replacement

“…7 Compared with anterior cervical discectomy and fusion, cervical total disc replacement (TDR) has a significantly better outcome in one-level disc disease with respect to symptom relief and maintenance of function. 8,9 In clinical practice, we found that some patients also get relief from vertigo as well as cervical spondylopathy after TDR. Although cervical TDR seems to be a promising method for the treatment of patients with single-level cervical spondylosis, no literature has addressed the effectiveness of cervical TDR with respect to alleviating cervical vertigo.…”

“… 7 Compared with anterior cervical discectomy and fusion, cervical total disc replacement (TDR) has a significantly better outcome in one-level disc disease with respect to symptom relief and maintenance of function. 8 , 9 …”

Enhanced Information Flow From Cerebellum to Secondary Visual Cortices Leads to Better Surgery Outcome in Degenerative Cervical Myelopathy Patients: A Stochastic Dynamic Causal Modeling Study With Functional Magnetic Resonance Imaging

“…In clinical practice, degenerative cervical myelopathy (DCM) is a common disease, which results in compression of the cervical spinal cord, leading to numerous neurological dysfunctions, including sensory dysfunctions, fine motor deficits, and incontinence (Lebl et al, 2011 ; Akter and Kotter, 2018 ; Davies et al, 2018 ; Badhiwala et al, 2020 ). In recent years, several atypical symptoms including blurred vision, dizziness, headache, and tinnitus were also frequently reported (Sun et al, 2013 , 2016 ; Muheremu et al, 2016 ). Among these neurological symptoms, the loss of fine motor control of the hands is the most frequently encountered symptom (Kalsi-Ryan et al, 2013 ), causing difficulty in the daily life of patients.…”

Cervicogenic visual dysfunction: an understanding of its pathomechanism

“…Our literature search demonstrated an inconsistency in the studies of surgical treatment in cervical spondylosis patients. Few reports suggested that double-door laminoplasty could significantly relieve the atypical symptoms including blurred vision [ 12 ], while others described improvement of atypical symptoms including blurred vision after artificial disc replacement [ 13 ]. Although anterior cervical discectomy and fusion (ACDF) significantly reduced the atypical symptoms, such as dizziness, headache, nausea, and palpitations, associated with cervical spondylotic myelopathy [ 14 ], relief from symptoms such as blurred vision, tinnitus, and memory are largely controversial.…”