Extensive Simultaneous Multisegment Laminectomy for Myelopathy Due to the Ossification of the Posterior Longitudinal Ligament in the Cervical Region

Miyazaki, Kazumi; Kirita, Yoshito

doi:10.1097/00007632-198607000-00005

Cited by 96 publications

(33 citation statements)

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“…Laminectomy, an accepted corrective procedure for CSM, nevertheless has the potential disadvantage of damaging the posterior structure of the cervical spine and causing spinal deformity such as kyphosis or slippage. [14][15][16][17][18] Laminoplasty is considered to be advantageous in preserving the posterior structure of the cervical spine, and numerous studies have reported satisfactory surgical outcomes with this procedure. 4,[7][8][9][10][11] To our knowledge, this is the first study on outcomes of laminoplasty in a largest series of patients with CSM.…”

Section: Discussionmentioning

confidence: 99%

Modified Double-Door Laminoplasty in Managing Multilevel Cervical Spondylotic Myelopathy

Machino

Yukawa

Hida

et al. 2013

Journal of Spinal Disorders &Amp; Techniques

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Section: Discussionmentioning

confidence: 99%

Modified Double-Door Laminoplasty in Managing Multilevel Cervical Spondylotic Myelopathy

Machino

Yukawa

Hida

et al. 2013

Journal of Spinal Disorders &Amp; Techniques

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“…The development of kyphosis did not appear to correlate with neurological deterioration. Miyazaki and Kirita 25 reported an 82% overall improvement rate in a study of 155 patients who underwent multilevel laminectomies; 11% of patients worsened, however. Follow-up was relatively short at only 1 year.…”

Section: Class III Studies: Retrospective Single-arm Studies Of Laminmentioning

confidence: 97%

Cervical laminectomy for the treatment of cervical degenerative myelopathy

Ryken

Heary²,

Matz

et al. 2009

SPI

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Object The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminectomy for the treatment of cervical spondylotic myelopathy (CSM). Methods The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminectomy and CSM. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results Laminectomy has improved functional outcome for symptomatic cervical myelopathy (Class III). The limitations of the technique are an increased risk of postoperative kyphosis compared to anterior techniques or laminoplasty or laminectomy with fusion (Class III). However, the development of kyphosis may not necessarily to diminish the clinical outcome (Class III). Conclusions Laminectomy is an acceptable therapy for near-term functional improvement of CSM (Class III). It is associated with development of kyphosis, however.

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“…9,21 In general, there are two major laminoplasty techniques, unilateral (open-door) and bilateral (midline opening). Submodifications of laminoplasty include the use of bone graft or instrumentation (miniplates).…”

Section: Discussionmentioning

confidence: 99%

Laminoplasty outcomes: is there a difference between patients with degenerative stenosis and those with ossification of the posterior longitudinal ligament?

Meyer

Mummaneni

2011

FOC

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Object Two common causes of cervical myelopathy include degenerative stenosis and ossification of the posterior longitudinal ligament (OPLL). It has been postulated that patients with OPLL have more complications and worse outcomes than those with degenerative stenosis. The authors sought to compare the surgical results of laminoplasty in the treatment of cervical stenosis with myelopathy due to either degenerative changes or segmental OPLL. Methods The authors conducted a retrospective review of 40 instrumented laminoplasty cases performed at a single institution over a 4-year period to treat cervical myelopathy without kyphosis. Twelve of these patients had degenerative cervical stenotic myelopathy ([CSM]; degenerative group), and the remaining 28 had segmental OPLL (OPLL group). The 2 groups had statistically similar demographic characteristics and number of treated levels (mean 3.9 surgically treated levels; p > 0.05). The authors collected perioperative and follow-up data, including radiographic results. Results The overall clinical follow-up rate was 88%, and the mean clinical follow-up duration was 16.4 months. The mean radiographic follow-up rate was 83%, and the mean length of radiographic follow-up was 9.3 months. There were no significant differences in the estimated blood loss (EBL) or length of hospital stay (LOS) between the groups (p > 0.05). The mean EBL and LOS for the degenerative group were 206 ml and 3.7 days, respectively. The mean EBL and LOS for the OPLL group were 155 ml and 4 days, respectively. There was a statistically significant improvement of more than one grade in the Nurick score for both groups following surgery (p < 0.05). The Nurick score improvement was not statistically different between the groups (p > 0.05). The visual analog scale (VAS) neck pain scores were similar between groups pre- and postoperatively (p > 0.05). The complication rates were not statistically different between groups either (p > 0.05). Radiographically, both groups lost extension range of motion (ROM) following laminoplasty, but this change was not statistically significant (p > 0.05). Conclusions Patients with CSM due to either degenerative disease or segmental OPLL have similar perioperative results and neurological outcomes with laminoplasty. The VAS neck pain scores did not improve significantly with laminoplasty for either group. Laminoplasty may limit extension ROM.

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Extensive Simultaneous Multisegment Laminectomy for Myelopathy Due to the Ossification of the Posterior Longitudinal Ligament in the Cervical Region

Cited by 96 publications

References 0 publications

Modified Double-Door Laminoplasty in Managing Multilevel Cervical Spondylotic Myelopathy

Modified Double-Door Laminoplasty in Managing Multilevel Cervical Spondylotic Myelopathy

Cervical laminectomy for the treatment of cervical degenerative myelopathy

Laminoplasty outcomes: is there a difference between patients with degenerative stenosis and those with ossification of the posterior longitudinal ligament?

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