Paralysis of the arm after posterior decompression of the cervical spinal cord

Tsuzuki, Nobuyoshi; Abe, Ryoji; Saiki, Kunio; Okai, K

doi:10.1007/bf00299446

Cited by 78 publications

(49 citation statements)

References 2 publications

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“…Tsuzukil et al [26] noted that a smaller laminar opening might suppress posterior shift of the dural tube. Such suppression with balanced traction forces on the bilateral roots might reduce the traction effect of the bulging dural tube on the roots, which can prevent postoperative C5 root injury.…”

Section: Optimal Los Following Odclmentioning

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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Section: Optimal Los Following Odclmentioning

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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“…In 1972, the idea of cervical laminoplasty was first introduced by Oyama and coworkers [1] by the name of ''Expansive lamina-Z-plasty'' to decrease these complications by preserving the posterior osseous structures of the cervical spine as much as possible. Thereafter, various methods of cervical laminoplasty have been developed in Japan [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…At present, the surgical methods of cervical laminoplasty are broadly divided into two types from the viewpoint of the site of osteotomy: open-door type [2,3,6] and double-door type [4,5]. In the open-door type, osteotomy is performed at one side of the lamina-facet junction.…”

Section: Introductionmentioning

confidence: 99%

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

et al. 2010

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The purpose of this study was to compare the degree of enlargement of the spinal canal between two methods of cervical laminoplasty (open-door laminoplasty and double-door laminoplasty) and to determine their appropriate surgical indications based on the results. Tension-band laminoplasty (TBL, one method of open-door type) was performed in 33 patients and double-door laminoplasty (DDL) in 20 patients. The operation level ranged from C2 to C7 in all patients. The width of the spinal canal and the inclination angle of the lamina at the C5 and C6 levels were measured using a computer software program (Image J) and pre-and postoperative CT films. Concerning the degree of enlargement of the spinal canal, the mean expansion ratio at the C5 level was 148.9% in TBL and 148.2% in DDL, and there was no significant difference between them. However, at the C6 level, it was 159.0% in TBL and 140.3% in DDL, which was significantly larger in TBL than DDL (p \ 0.05). The increase of inclination angle of the lamina was 11.0°in TBL and 19.0°in DDL at the C5 level, and 9.2°in TBL and 19.3°in DDL at the C6 level. At both the C5 and C6 levels, it was significantly larger in DDL than TBL (p \ 0.0001). In conclusion, the appropriate surgical indications of TBL were considered to be (1) cervical spondylotic myelopathy (CSM) combined with hemilateral radiculopathy, (2) severe prominence of ossification of the posterior longitudinal ligament (OPLL), and (3) patients with tiny spinous processes who cannot undergo DDL. Those of DDL were considered to be (1) usual CSM, (2) small and slight prominence of OPLL, (3) CSM combined with bilateral radiculopathy, and (4) cervical canal stenosis combined with instability necessitating posterior spinal instrumentation surgery.

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“…Furthermore, the C-5 segment is usually the point at which the extent of posterior shift of the cord is greatest. Using cadavers, Tsuzuki et al 32,33 demonstrated that impingement of the nerve root occurs inside the uncovertebral joint with backward shifting of the spinal cord after laminoplasty.…”

Section: Discussionmentioning

confidence: 99%

Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different?

Gandhoke

Rowland

et al. 2011

FOC

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Object Both anterior cervical corpectomy and fusion (ACCF) and laminoplasty are effective treatments for selected cases of cervical stenosis. Postoperative C-5 palsies may occur with either anterior or posterior decompressive procedures; however, a direct comparison of C-5 palsy rates between the 2 approaches is not present in the literature. The authors sought to compare the C-5 palsy rate of ACCF versus laminoplasty. Methods The authors conducted a retrospective review of 31 ACCF (at C-4 or C-5) and 31 instrumented laminoplasty cases performed to treat cervical stenosis. The demographics of the groups were similar except for age (ACCF group mean age 53 years vs laminoplasty group mean age 62 years, p = 0.002). The mean number of levels treated was greater in the laminoplasty cohort (3.87 levels) than in the ACCF cohort (2.74 levels, p < 0.001). The mean preoperative Nurick grade of the laminoplasty cohort (2.61) was higher than the mean preoperative Nurick grade of the ACCF cohort (1.10, p < 0.001). Results The overall clinical follow-up rate was 100%. The mean overall clinical follow-up was 15 months. There were no significant differences in the estimated blood loss or length of stay between the 2 groups (p > 0.05). There was no statistical difference between the complication or reoperation rates between the 2 groups (p = 0.184 and p = 0.238). There were 2 C-5 nerve root pareses in each group. Three of the 4 patients recovered full deltoid function, and the fourth patient recovered nearly full deltoid function at final follow-up. There was no statistical difference in the rate of deltoid paresis (6.5%) between the 2 groups (p = 1). Conclusions Both ACCF and laminoplasty are effective treatments for patients with cervical stenosis. The authors found no difference in the rate of deltoid paresis between ACCF and laminoplasty to treat cervical stenosis.

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Paralysis of the arm after posterior decompression of the cervical spinal cord

Cited by 78 publications

References 2 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

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

Anterior corpectomy versus posterior laminoplasty: is the risk of postoperative C-5 palsy different?

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