Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy

Kohno, Kanehisa; Kumon, Yoshiaki; Oka, Yoshihisa; Matsui, Shinobu; Ohue, Shiro; Sakaki, Saburo

doi:10.1016/s0090-3019(97)00166-3

Cited by 151 publications

(113 citation statements)

References 28 publications

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“…In conclusion, widening of the AP diameter by approximately 4.1-5.2 mm is obtained when LOS of 10-12 mm at C3-C7 is made, which is sufficient for obtaining good operative result [1,21]. But, in some patients who suffered from serious ossification of the posterior longitudinal ligament, the greater opening size should be used to achieve a wider spinal canal than used in patients with cervical spondylotic myelopathy.…”

Section: Optimal Los Following Odclmentioning

confidence: 89%

“…Hirabayashi [1] stated that widening of the AP diameter by approximately 4 or 5 mm is sufficient for obtaining good operative result. Kohno [21] stated that good recovery group showed optimal widening by 5 mm in the diameter and by 95 mm 2 in the canal area.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal increase in the sagittal diameter of the stenotic canal by laminoplasty is [4-5 mm [1,21]. Therefore, when the LOS was \10 mm at C3-C7, the postoperative SCD and canal volume increases were inadequate and would not relieve spinal cord compression.…”

Section: Optimal Los Following Odclmentioning

confidence: 99%

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Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Gu¹,

Zhang

Shen

et al. 2015

Eur Spine J

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Objective To clarify the relationship between the laminoplasty opening size (LOS), the laminoplasty opening angle (LOA) and the increase in sagittal canal diameter (SCD) and to predict the amount of canal enlargement during open-door cervical laminoplasty (ODCL). Methods Formula describing the relationship between LOS and LOA, the increase in SCD was deduced. The parameters of pre-and postoperative computed tomography scans of 36 patients who had undergone laminoplasty surgery were measured by picture archiving and communication system (PACS) software, and the amount of canal enlargement of these patients was predicted when the opening size of laminoplasty was 8, 10, 12, 14 and 16 mm according to the formula. Results For equivalent LOS, the amount of canal enlargement with each opening size differed throughout the cervical region. When the C3-C7 LOS was 10 mm the SCD increased [4.1 mm, and the canal area increased in C3-C6 [88 mm 2 , and the canal area increased in C7 [ 80 mm 2 .When the C3-C7 LOS was 12 mm, the SCD increased [5.2 mm, and the canal area increased in C3-C6 [104 mm 2 , and the canal area increased in C7 [ 94 mm 2 . Conclusion Formula accurately showed the relationship between the LOS and the increase in SCD achieved by ODCL. The amount of canal enlargement following ODCL could be predicted by the formula. LOS of 10-12 mm at C3-C7 might be optimal during ODCL.

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Section: Optimal Los Following Odclmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Gu¹,

Zhang

Shen

et al. 2015

Eur Spine J

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“…Present surgical methods include anterior (Cloward or Smith-Robinson technique [40]) or posterior (laminectomy, hemilaminectomy) approach, both with good and probably equal results; and recently open-door laminoplasty and vertebral corpectomy have been added [21]. The indication for surgery is mostly a severe and progressive course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

Kadaňka

Bednařík

Voháňka

et al. 2000

European Spine Journal

125

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IntroductionSpondylotic cervical myelopathy (SCM) is the most frequent cause of myelopathy in those over the age of 50 [48]. It is believed to have a generally progressive course over a period of years, with sudden acceleration especially following a slight head and neck injury, leading to significant disability [24,45,49]. The treatment of SCM remains a problem, particularly in the mild and moderate forms without rapid progression. There is no strong evidence to show that decompressive surgery with an anterior or posterior approach can improve the clinical outcome of the victims of this disease. This uncertainty persists despite the fact that decompression is a logical answer to the stenotic process, and that this approach is supAbstract A prospective randomised 2-year study was performed to compare the conservative and operative treatment of mild and moderate forms of spondylotic cervical myelopathy (SCM). Forty-eight patients presenting with the clinical syndrome of SCM, with a modified Japanese Orthopaedic Association (mJOA) score of 12 points or more, were randomised into two groups. Group A, treated conservatively, consisted of 27 patients, mean age 55.6 ± 8.6 years, while group B was treated surgically (21 patients, mean age 52.7 ± 8.1 years). The clinical outcome was measured by the mJOA score, recovery rate (RR), timed 10 m walk, score of daily activities (recorded by video and evaluated by two observers blinded to the therapy), and by the subjective assessment of the patients at 6, 12, and 24 months of the follow-up. There was, on average, no significant deterioration in mJOA score, recovery ratio, or timed 10 m walk within either group during the 2 years of follow-up. In the surgery group there was a slight decline in the scores for daily activities and subjective evaluation. A comparison of the two groups showed no significant differences in changes over time in mJOA score or quantified gait, but there were significant differences in the score of daily activities recorded by video at 24 months, which was a little lower in the surgical group, and also in RR and subjective evaluation, which were both worse in the surgical group at months 12 and 24. However, at month 6, this last parameter was significantly better in the surgical than in conservative group. Surgical treatment of mild and moderate forms of SCM in the present study design, comprising the patients with no or very slow, insidious progression and a relatively long duration of symptoms, did not show better results than conservative treatment over the 2-year follow-up.

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“…However, the ideal surgical treatment option for cervical spondylotic myelopathy remains controversial. So far, published data could not report one surgical technique to be superior to others [6,8,9,11,13,17,18,20]. The major disadvantage of posterior surgical approaches is cervical muscular pain due to an extensive dissection of the paracervical muscles from the spinous processes and laminae, especially in multilevel maneuvers.…”

Section: Discussionmentioning

confidence: 99%

Full-endoscopic cervical arcocristectomy for the treatment of spinal stenosis: results of a cadaver study

et al. 2012

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Purpose Cervical spondylotic myelopathy is a multifactorial disease that is directly correlated by the degree of spinal stenosis. Surgery remains the best therapy. A posterior approach is often recommended in patients with multilevel dorsal cervical compression. Aim of the present experimental study was to evaluate the feasibility of a fullendoscopic arcocristectomy in a cadaver study. Methods We performed full-endoscopic arcocristectomy on ten formalin-fixed human cervical specimens. Before and after decompression we obtained high-resolution computerized tomography (CT) data to evaluate the diameter of the cervical spinal canal. Results Overall, surgery was possible on 55 segments in ten cadaver specimens. A mean increase of 4.1 mm (±1.2 mm) in the sagittal diameter of the cervical spinal canal could be achieved (p \ 0.05, t test). Conclusions The full-endoscopic arcrocristectomy is feasible and achieves a sufficient decompression. This minimal invasive technique protects most of the dorsal structures and therefore probably preserves biomechanical functions, which has to be proven in future studies.

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Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy

Cited by 151 publications

References 28 publications

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study

Full-endoscopic cervical arcocristectomy for the treatment of spinal stenosis: results of a cadaver study

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