scholarly journals Comparison of Imaging Parameters between a New Cervical Full Lamina Back Shift Spinal Canal Enlargement Technique and Single Open‐Door Laminoplasty for Multisegment Cervical Spondylotic Myelopathy

2021 ◽  
Author(s):  
Xiao‐nan Wang ◽  
Yi‐bo Zhao ◽  
Xiang‐dong Lu ◽  
Xiao‐feng Zhao ◽  
Zhi‐feng Fan ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Open Door ◽  
Imaging Parameters ◽  
Canal Enlargement

scholarly journals Comparative Study of Imaging Parameters between a New Cervical Full Lamina Back Shift Spinal Canal Enlargement Technique and Single Open-door Laminoplasty for Multisegment Cervical Spondylotic Myelopathy

2020 ◽  
Author(s):  
Xiaonan Wang ◽  
Yibo Zhao ◽  
Xiangdong Lu ◽  
Xiaofeng Zhao ◽  
Detai Qi ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Sectional Area ◽  
Open Door ◽  
Mr Images ◽  
Titanium Plate ◽  
Cross Sectional ◽  
Imaging Parameters ◽  
Canal Enlargement

Abstract Purpose To provide imaging evidence of the feasibility and clinical efficacy of a new full lamina back shift spinal canal enlargement technique by comparing its imaging parameters to those of single open-door miniature titanium plate internal fixation.Methods A retrospective analysis was conducted on 64 patients with multisegment cervical spondylotic myelopathy caused by cervical stenosis. Of these, 32 underwent the new full lamina back shift spinal canal enlargement technique (observation group), and 32 underwent single open-door miniature titanium plate internal fixation (control group). The CT data of both groups were imported into Mimics 17.0 software to measure the median sagittal diameter and cross-sectional area of the spinal canal. Photoshop CS5 was employed to measure the drift distance of the spinal cord on MR images to perform a comparative study of the imaging parameters from the two groups.Results The T2-weighted MR images in both groups showed continuous recovery of the cerebrospinal fluid signal in the C3–C7 range. The new full lamina back shift spinal canal enlargement technique was significantly superior to single open-door miniature titanium plate internal fixation with respect to the spinal canal cross-sectional area and the median sagittal diameter (P<0.05). No significant difference was detected in the drift distance of the spinal cord between the two groups (P>0.05).Conclusion The new full lamina back shift spinal canal enlargement technique achieved a thorough spinal canal decompression effect on imaging while ensuring a reasonable spinal drift distance and few surgical complications. The clinical curative effect of the new technique was precise.

scholarly journals Three-dimensional computed tomography for evaluation of cervical spinal canal enlargement after en bloc open-door laminoplasty

Spinal Cord ◽  
1997 ◽  
Vol 35 (10) ◽  
pp. 674-679 ◽  
Author(s):  
Hisatoshi Baba ◽  
Kenzo Uchida ◽  
Yasuhisa Maezawa ◽  
Nobuaki Furusawa ◽  
Makoto Wada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Spinal Canal ◽  
Three Dimensional ◽  
Open Door ◽  
En Bloc ◽  
Cervical Spinal Canal ◽  
Canal Enlargement

A New Posterior Extensor Attachment-Point Reconstruction Technique for Cervical Spondylotic Myelopathy Involving C2 Segment: Clinical Outcome and Safety

2020 ◽  
Author(s):  
Hai-Yun Yang ◽  
Yun-Ge Zhang ◽  
Dong Zhao ◽  
Gui-Ming Sun ◽  
Yi Ma ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Plate Fixation ◽  
Japanese Orthopaedic Association ◽  
Neurological Dysfunction ◽  
Reconstruction Technique ◽  
Open Door ◽  
Titanium Plate ◽  
Attachment Point ◽  
Curvature Index ◽  
Axial Symptoms

Abstract Background and Study Aim Cervical spondylotic myelopathy (CSM) is a common degenerative disease that mainly occurs in elder patients, leading to different degrees of neurological dysfunction. Spinal cord involvement is mainly distributed at the C3–C7 segments, but it may also involve up to the C2 level. This study aimed to assess the clinical efficacy and safety of open-door laminoplasty using a new extensor attachment-point reconstruction technique for treating CSM involving the C2 segment. Patients and Methods Fifty-nine patients with CSM involving the C2 segment and undergoing open-door laminoplasty were included in this retrospective study. Based on the titanium plate used in the operation, patients were divided into two groups, a reconstructed titanium plate fixation (RPF) group (n = 28) and a conventional titanium plate fixation (CPF) group (n = 31). Improvements in neurological function, cervical range of motion (ROM), cervical curvature index (CCI), preservation of posterior cervical muscle mass, and axial symptoms were compared between the two groups. Results There were no significant differences in operative time and intraoperative blood loss between the groups (p > 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased in both groups postsurgery (p < 0.05); the neurological recovery rate was similar between the two groups (64.1 ± 13.3% vs. 65.9 ± 14.7%, p > 0.05). There was no significant loss of cervical ROM in either group (p > 0.05). The anteroposterior dural sac diameter at the C2 level was significantly enlarged in both groups (p < 0.05). Alternatively, CCI was significantly reduced in the CRP group (p < 0.05) but unchanged in the RPF group (p > 0.05). The cross-sectional area of the posterior cervical muscles was also significantly reduced in the CPF group (p < 0.05) but maintained in the RPF group (p > 0.05). Finally, axial symptoms were more severe in the CPF group than in the RPF group (p < 0.05). Conclusion Laminoplasty is an effective surgical procedure for CSM involving the C2 segment. The reconstructed titanium plate achieved superior maintenance of cervical curvature and reduced both muscle atrophy and severity of axial symptoms compared with titanium conventional plates.

Open-Door versus French-Door Laminoplasty for Patients with Multisegmental Cervical Spondylotic Myelopathy: A Systematic Review and Meta-analysis

2021 ◽  
Vol 155 ◽  
pp. 82-93
Author(s):  
Tiantian Chen ◽  
Xun Zhang ◽  
Fanchao Meng ◽  
Tingxin Zhang ◽  
Yibo Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spondylotic Myelopathy ◽  
Meta Analysis ◽  
Open Door

scholarly journals Myovascular Preserving Open-Door Laminoplasty for Cervical Spondylotic Myelopathy With Miniplate Fixation

10.14444/7062 ◽  
2020 ◽  
Vol 14 (4) ◽  
pp. 476-482
Author(s):  
YAWARA EGUCHI ◽  
MUNETAKA SUZUKI ◽  
HAJIME YAMANAKA ◽  
HIROSHI TAMAI ◽  
TATSUYA KOBAYASHI ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Open Door

scholarly journals Laminectomy versus open-door laminoplasty for cervical spondylotic myelopathy: A clinical outcome analysis

2020 ◽  
Vol 11 ◽  
pp. 73 ◽  
Author(s):  
Mauro Dobran ◽  
Fabrizio Mancini ◽  
Riccardo Paracino ◽  
Simona Lattanzi ◽  
Lucia di Somma ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Clinical Outcome ◽  
Cervical Spondylotic Myelopathy ◽  
Outcome Analysis ◽  
Complication Rates ◽  
Open Door ◽  
Analog Scale ◽  
Geriatric Population ◽  
Decompressive Laminectomy ◽  
Japanese Orthopedic Association

Background: Cervical spondylotic myelopathy (CSM) is one of the most common diseases in the geriatric population. Decompressive laminectomy or laminoplasty is the predominant surgical procedure of choice, but there remains debate as to which procedure is optimal for managing CSM. Methods: Here, we retrospectively analyzed 64 patients with CSM undergoing laminectomy (39 patients) versus laminoplasty (25 patients). The data were collected included respective Japanese orthopedic association (JOA) scores, Nurick grades, and Visual analog scale (VAS) values preoperatively versus 12 months postoperatively. Results: The JOA score after 1 month improved in both groups utilizing laminectomy or laminoplasty. However, at 12 postoperative months, the JOA scores and Nurick grades showed greater improvement following laminoplasty, despite no differences in postoperative pain and complication rates. Conclusion: Patients with cervical spondylotic myelopathy undergoing laminoplasty (25 patients) showed better 12-month postoperative outcomes (JOA scores and Nurick grades) versus those having laminectomies (39 patients).

scholarly journals Outcome and Predictive Factors in Rapid Progressive Cervical Spondylotic Myelopathy: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Haimiti Abuduaini ◽  
Hao Liu ◽  
Beiyu Wang ◽  
Yang Meng ◽  
Yi Yang ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Compression Ratio ◽  
Spinal Canal ◽  
Signal Intensity ◽  
Cervical Spondylotic Myelopathy ◽  
Neurological Deterioration ◽  
Neurological Dysfunction ◽  
Canal Diameter ◽  
History Of ◽  
Disc Level

Abstract Background: To evaluate epidemiological, clinical and radiographic features in the development and prognosis of rapid progressive cervical spondylotic myelopathy (rp-CSM).Methods: A retrospective study of 175 patient records was performed between March 2011 and January 2017. Patients were divided into rp-CSM group and chronic CSM (c-CSM) group according to the deterioration time and severity of preoperative neurological dysfunction. After selection, 25 rp-CSM patients were matched to a control group of 75 patients with c-CSM. The clinical outcomes were assessed by the Modified Japanese Orthopaedic Association (mJOA) score at six different follow-up time points. The imaging parameters including Torg-Pavlov Ratio (TPR) on conventional lateral x-ray and magnetic resonance images (MRI), intervertebral disc level compression ratio and increased signal intensity (ISI) on T2W1 were analyzed between the two groups, and predictors for rapid neurological dysfunction in CSM patients were evaluated using multivariate analysis.Results: Twenty-five patients experienced rp-CSM (18 males; median age 59.04 ± 12.81 years) and were matched with Seventy-five control subjects that with CSM without rapid progression (54 males; median age 56.88 ± 12.31 years). The average time to develop severe neurological deterioration was 0.8 month in rp-CSM group and 24 month in c-CSM group (p=0.001), preoperative mJOA were 6 in rp-CSM patients and 12 in c-CSM patients (p=0.014) and rp-CSM patients demonstrated worse outcomes than the controls in one year after surgery (mJOA improvement rate 54.5% and 80%, p=0.021). There were no differences between the two groups except the history of diabetes and the long-term smoking in basic condition, radiographic measurements signified that TPR MRI, intervertebral disc level compression ratio and increased signal intensity (ISI) on T2W1 were inferior in patients with rp-CSM than patients with c-CSM. Regression analysis verified that the history of diabetes, TPR MRI < 0.4, compression ratio ≥50%, the sagittal diameter of ISI ≥50% of spinal canal diameter on T2W1 have significant correlations with the rapid progressive neurological dysfunction in patients with CSM. Conclusion: The prognosis of rapid progressive CSM is worse than that of common chronic CSM. The rapid neurological deterioration can be identified by TPR MRI (< 0.4), compression ratio (≥50%), sagittal diameter of ISI (≥50% of spinal canal diameter). Besides, a history of diabetes was also a negative factor for these patients.

Effective lordosis: analysis of sagittal spinal canal alignment in cervical spondylotic myelopathy

2009 ◽  
Vol 11 (6) ◽  
pp. 667-672 ◽  
Author(s):  
David E. Gwinn ◽  
Christopher A. Iannotti ◽  
Edward C. Benzel ◽  
Michael P. Steinmetz
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Planning ◽  
Interobserver Reliability ◽  
Straight Line ◽  
Angular Measurements ◽  
Sagittal Deformity ◽  
Straight Line Method

Object Analysis of cervical sagittal deformity in patients with cervical spondylotic myelopathy (CSM) requires a thorough clinical and radiographic evaluation to select the most appropriate surgical approach. Angular radiographic measurements, which are commonly used to define sagittal deformity, may not be the most appropriate to use for surgical planning. The authors present a simple straight-line method to measure effective spinal canal lordosis and analyze its reliability. Furthermore, comparisons of this measurement to traditional angular measurements of sagittal cervical alignment are made in regards to surgical planning in patients with CSM. Methods Twenty preoperative lateral cervical digital radiographs of patients with CSM were analyzed by 3 independent observers on 3 separate occasions using a software measurement program. Sagittal measurements included C2–7 angles utilizing the Cobb and posterior tangent methods, as well as a straight-line method to measure effective spinal canal lordosis from the dorsal-caudal aspect of the C2–7 vertebral bodies. Analysis of variance for repeated measures or Cohen 3-way (kappa) correlation coefficient analysis was performed as appropriate to calculate the intra- and interobserver reliability for each parameter. Discrepancies in angular and effective lordosis measurements were analyzed. Results Intra- and interobserver reliability was excellent (intraclass coefficient > 0.75, kappa > 0.90) utilizing all 3 techniques. Four discrepancies between angular and effective lordotic measurements occurred in which images with a lordotic angular measurement did not have lordosis within the ventral spinal canal. These discrepancies were caused by either spondylolisthesis or dorsally projecting osteophytes in all cases. Conclusions Although they are reliable, traditional methods used to make angular measurements of sagittal cervical spine alignment do not take into account ventral obstructions to the spinal cord. The effective lordosis measurement method provides a simple and reliable means of determining clinically significant lordosis because it accounts for both overall alignment of the cervical spine as well as impinging structures ventral to the spinal cord. This method should be considered for use in the treatment of patients with CSM.

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