Effectiveness of the Laminoplasty in the Elderly Patients with Cervical Spondylotic Myelopathy

Abstract

ObjectiveThe purpose of this study is to evaluate clinical and radiological outcomes analysis of the laminoplasty in the elderly patients, and to compare with the non-elderly patients.MethodsA retrospective study of the short term result in patients who had treated with the laminoplasty for cervical spondylotic myelopathy (CSM) was performed. From January 2008 to December 2012, total 62 patients were operated with single open-door technique because of CSM; 28 patients were the elderly and 34 patients were the non-elderly. We evaluated some factors including sex, symptom duration, estimated blood loss during operation, operation time, hospitalization day, complications, pre- and postoperative modified Japanese Orthopedic Association (mJOA) score, recovery rate of mJOA score, achieved mJOA score, mean cervical canal width and expansion ratio of antero-posterior diameter in order to identify difference between the two group. Clinical outcomes were calculated with the recovery rate of mJOA score at the time of one year after operation.ResultsMean age were 71.9 in the elderly group and 52.9 in the non-elderly group. Although postoperative mJOA score in the elderly group was lower than that of the non-elderly group, achieved mJOA score was statistically same between the two groups. Other clinical and radiological outcomes were also statistically same.ConclusionWe conclude that the laminoplasty also assures good clinical outcomes in the elderly patients with CSM, same as in the non-elderly group.

The Reliability of the Ultrasonic Bone Scalpel in Cervical Spondylotic Myelopathy: A Comparative Study of 46 Patients

“…(4, [11][12][13]19,22,25) Blood loss has been reported at 250-380ml in cases of laminectomy applied for CSM. In a study by Bydon et al (2), pediatric cases of achondroplasia operated on with UBS and HSD were compared and dura injury was reported in 9 (45%) cases where HSD had been used.…”

“…Laminectomy surgery can be applied with different techniques and different instruments (14,19). Classic cervical laminectomy is performed with a Kerrison rongeur.…”

Cervical Spondylotic Myelopathy: Pathophysiology and Surgical Approaches

“…In this paper [40], they explained that this was due to the non-CSM diseases including lumbar spine canal stenosis, osteoarthritis of knee, carpal tunnel syndrome, and stress urine incontinence. Moreover, Son et al [41] reported that laminoplasty resulted in good clinical outcomes in the elderly (65 years old), which were the same as in the non-elderly subjects. Similarly, Heller et al [42] reported that both laminoplasty approaches exhibited similar good clinical outcomes.…”

“…Similarly, Heller et al [42] reported that both laminoplasty approaches exhibited similar good clinical outcomes. Furthermore, the recovery rate (RR) of laminoplasty was greater than 50% in the short-term, mid-term, and long-term follow-up [35,[38][39][40][41]. On the other hand, Uehara et al [34] reported that RR was 47.1% in the final follow-up, but 55.9% immediately after operation.…”

“…Two most common laminoplasty techniques are open-door technique and french-door technique, and both techniques provide adequate expansion of cervical canal post operation [35,41,45,46]. However, several studies reported that open-door technique provided a wider expansion ratio than french-door technique in the C6 level and same expansion ratio in the C5 level [45,46].…”