Long-Term Follow-up Studies of Open-Door Expansive Laminoplasty for Cervical Stenotic Myelopathy

Satomi, Kazuhiko; Nishu, Yukimi; Kohno, Touru; Hirabayashi, Kiyoshi

doi:10.1097/00007632-199403000-00003

Cited by 344 publications

(188 citation statements)

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“…Although there were many reports of good postoperative neurological improvements after laminoplasty for cervical myelopathy [12,23,28], several postoperative problems have also been reported, including late deterioration of myelopathy symptoms [9,15,20,23], C5 root palsies [3,16,17,21,28], axial symptoms [7,11,14,24,25,31], cervical malalignment [8,15,26,28,30] and loss of flexion-extension ROM [1,5,6,13,15,22,26,28,30]. Especially in recent years, a great deal of attention has been paid to axial symptoms as postoperative complications which adversely affect patients' quality of life.…”

Section: Discussionmentioning

confidence: 99%

Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

et al. 2007

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Although difficulties with neck mobility often interfere with patients' activities of daily living (ADL) after cervical laminoplasty, there was no detailed study on the relation between the limitations of ADL accompanying postoperative reduced neck mobility and the cervical posterior approach. The aim of this study was to compare retrospectively the frequency of limitations of ADL accompanying neck mobility after laminoplasty preserving the semispinalis cervicis inserted into the C2 spinous process with that after laminoplasty reattaching the muscle to C2. Forty-nine patients after C4-C7 laminoplasty with C3 laminectomy preserving the semispinalis cervicis inserted into C2 (Group A) and 24 patients after C3-C7 laminoplasty reattaching the muscle (Group B) were evaluated. The frequency of postoperative limitations of ADL accompanying each of three neck movements of extension, flexion and rotation were investigated. The postoperative O-C7 angles at extension and flexion was measured on lateral extension and flexion radiographs of the cervical spine, respectively. The postoperative cervical range of motion in rotation was measured in the cranial view using a digital camera. Frequency of limitations of ADL accompanying extension was lower (P = 0.037) in Group A (2%) than in Group B (17%). Frequency of limitations of ADL accompanying flexion was similar in Group A (8%) and Group B (4%). Frequency of limitations of ADL accompanying rotation was lower (P = 0.031) in Group A (12%) than in Group B (33%). Average O-C7 angle at extension was significantly larger (P = 0.002) in Group A (147°) than in Group B (136°). Average O-C7 angle at flexion was similar in Group A (93°) and Group B (91°). Average range of motion in rotation was significantly larger (P = 0.004) in Group A (110°) than in Group B (91°). This retrospective study suggested that the frequency of limitations of ADL accompanying neck extension or rotation was lower after laminoplasty preserving the semispinalis cervicis inserted into C2 than after laminoplasty reattaching the muscle.

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Section: Discussionmentioning

confidence: 99%

Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

et al. 2007

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“…Excellent longterm results have been reported using this technique [3][4][5][6][7]. Clinical follow-up studies have shown that laminoplasty generally results in greater patient satisfaction and lower complication rates than laminectomy [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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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“…Laminoplasty provides spinal cord decompression via canal expansion, thus allowing the cord to migrate posteriorly while preserving posterior bone stock and architecture. Various laminoplasty techniques have been described, and the literature is replete with follow-up studies that have demonstrated better clinical outcomes and patient satisfaction [3,20,21,23,24,26,35,36,37,43,48,50]. Relatively few reports have demonstrated the biomechanical effects laminoplasty has on the cervical spine [4,28,29].…”

Section: Discussionmentioning

confidence: 99%

“…A bone block or plate is used to reconnect the separated laminae [22,23]. Excellent long-term results have been reported using this technique [26,43]. However, due to the asymmetry created by the procedure, certain muscle groups may lose as much as 80% of their cross-sectional area due to disuse atrophy [12].…”

mentioning

confidence: 99%

Biomechanics of cervical laminoplasty: kinetic studies comparing different surgical techniques, temporal effects and the degree of level involvement

Puttlitz

Deviren

Smith

et al. 2004

European Spine Journal

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Laminoplasty is a common surgical technique used to treat cervical myelopathy. Both voids and contradictory information exist in the literature with regard to the initial and long-term biomechanical consequences of cervical laminoplasty. In order to clarify the existing literature, as well as provide clinically useful information, we identified three specific aims: (1) to measure the long-term differences in kinetics between the open door laminoplasty (ODL) and French door laminoplasty (FDL) techniques; (2) to delineate differences in primary and long-term cervical motion after laminoplasty; and (3) to determine whether inclusion of additional levels in the laminoplasty procedure results in a change in immediate cervical biomechanics. The study design involved both an animal (caprine) model and in vitro surgical simulation. We kinematically evaluated the cervical spine specimens (C2-C7) by applying pure bending moment loads to the cephalad vertebra (C2), while constraining the caudal vertebra (C7). Resultant intervertebral rotations (C3-C6) were determined via stereophotogrammetry. Overall, the data indicate that both FDL and ODL significantly reduce range of motion 6 months postoperatively, compared with the un-operated spine. There were no significant differences between the two techniques after 6 months. We also showed that ODL produces a significant reduction in motion 6 months postoperatively compared with the immediate postoperative condition. Finally, the data indicated that extending the laminoplasty from two to four levels did not significantly change range of motion. The choice of technique should be based upon the surgeon's experience with these technically demanding procedures. In addition, initial stability considerations should not affect the decision to extend the laminoplasty to adjacent levels. Finally, the data also suggest that early changes in biomechanics should not be a major factor when considering whether immobilization of the cervical spine is necessary after laminoplasty. In fact, our temporal study, as well as previously reported clinical data, indicates that one should expect significantly decreased intervertebral motion 6 months after laminoplasty. Therefore, early physical therapy should be considered to preserve a more physiologic pattern of cervical range of motion.

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Long-Term Follow-up Studies of Open-Door Expansive Laminoplasty for Cervical Stenotic Myelopathy

Cited by 344 publications

References 0 publications

Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis

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

Biomechanics of cervical laminoplasty: kinetic studies comparing different surgical techniques, temporal effects and the degree of level involvement

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