New double-door laminoplasty procedure for the axis to preserve all muscular attachments to the spinous process

2002 ◽  
Vol 12 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Tateru Shiraishi ◽  
Yoshiyuki Yato
Keyword(s):  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Spinous Process ◽  
Posterior Longitudinal Ligament ◽  
Neurological Improvement ◽  
Radiological Evidence

To prevent the occurrence of postoperative cervical malalignment, which is often a complication of conventional axial laminectomy or laminoplasty, the authors developed a new double-door laminoplasty procedure in which the C-2 spinal canal is expanded while all the muscular attachments to each split half of the spinous process remain undisturbed. In conjunction with laminoplasties at other levels, this procedure was performed in five patients with ossification of the posterior longitudinal ligament and cervical myelopathy. Neurological improvement was demonstrated in each patient, and there was no radiological evidence of cervical malalignment. The technique for this procedure is described and its usefulness in preventing postoperative spinal malalignment is discussed.

scholarly journals Severe Facet Joint Arthrosis Caused C7/T1 Myelopathy: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Toshimi Aizawa ◽  
Hiroshi Ozawa ◽  
Takeshi Hoshikawa ◽  
Takashi Kusakabe ◽  
Eiji Itoi
Keyword(s):  
Cervical Myelopathy ◽  
Rare Case ◽  
Facet Joint ◽  
Spinous Process ◽  
Intervertebral Disc Herniation ◽  
Facet Joints ◽  
Single Level ◽  
Neurological Improvement ◽  
Bony Spur ◽  
Radiological Examinations

Cervical myelopathy is caused by degenerative processes of the spine including intervertebral disc herniation and posterior spur usually developing at C3/4 to C5/6. C7/T1 single level myelopathy is very rare because of the anatomical characteristics. Facet joint arthrosis can be a cause of cervical myelopathy but only a few cases have been reported. The authors report an extremely rare case of C7/T1 myelopathy caused by facet joint arthrosis. A 58-year-old male presented with hand and gait clumsiness. The radiological examinations revealed severe C7/T1 facet joint arthrosis with bony spur extending into the spinal canal, which compressed the spinal cord laterally. The T1 spinous process indicated nonunion of a “clay-shoveler's” fracture, which suggested that his cervico-thoracic spine had been frequently moved, and thus severe arthrosis had occurred in the facet joints. A right hemilaminectomy of C7 and C7/T1 facetectomy with single level spinal fusion led to complete neurological improvement.

A cervical myelopathy associated with an anomaly of the axis: Two case reports of invaginated spinous process of the axis with spina bifida into the spinal canal

2016 ◽  
Vol 21 (4) ◽  
pp. 557-561 ◽  
Author(s):  
Yutaka Horinouchi ◽  
Toshiya Tachibana ◽  
Keishi Maruo ◽  
Shinichi Inoue ◽  
Fumihiro Arizumi ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Case Reports ◽  
Spinous Process

Postoperative displacement of hydroxyapatite spacers implanted during double-door laminoplasty

2009 ◽  
Vol 10 (6) ◽  
pp. 551-556 ◽  
Author(s):  
Takashi Kaito ◽  
Noboru Hosono ◽  
Takahiro Makino ◽  
Noriyoshi Kaneko ◽  
Masato Namekata ◽  
...  
Keyword(s):  
Neck Pain ◽  
Dura Mater ◽  
Cervical Myelopathy ◽  
Neurological Outcome ◽  
Spinal Canal ◽  
Spinous Process ◽  
Original Position ◽  
Ct Scans ◽  
Good Neurological Outcome ◽  
Compressive Myelopathy

Object Double-door laminoplasty using hydroxyapatite (HA) spacers has been widely performed for compressive cervical myelopathy and has provided good neurological outcome. Although HA spacers are used for preventing reclosure of the opened laminae, they are often displaced or dislocated from their original position. The authors investigated the incidence and patterns of postoperative HA spacer displacement to determine the reasons for this unfavorable event. Methods Eighty-six patients with compressive myelopathy underwent double-door laminoplasty in which a total of 278 HA spacers were used. The displacement of HA spacers and opened laminae were assessed using postoperative lateral radiographs and CT scans. Results Postoperative dorsal migration > 2 mm was found in 116 (42%) of 278 implanted HA spacers. In addition, 33 (38%) of 86 HA spacers rotated > 10° and 29 (34%) of the 86 opened laminae tilted > 10°. Moreover, deformation of the newly formed spinal canal was observed in 51 (59%) of 86 cases, and bone fusion between the HA spacer and spinous process was achieved in only 15 (8.7%) of 172 cases. Neurological worsening and neck pain, however, were not associated with displacement of HA spacers or deformation of the spinal canal. Conclusions In double-door laminoplasty, postoperative displacement of the HA spacer with deformation of the enlarged spinal canal occurred frequently. Hydroxyapatite spacers tend to become displaced after surgery. Placing the HA spacer at the base of the spinous process close to the dura mater may prevent postoperative displacement.

scholarly journals Cervical myelopathy due to ossification of the posterior longitudinal ligament in the aged patients.

1990 ◽  
Vol 39 (1) ◽  
pp. 264-266
Author(s):  
Yutaka Itou ◽  
Shinya Kawai ◽  
Kouzou Sunago ◽  
Minoru Saika ◽  
Tosihiko Taguchi ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Posterior Longitudinal Ligament ◽  
Aged Patients

scholarly journals Neurological improvement is associated with neck pain attenuation after surgery for cervical ossification of the posterior longitudinal ligament

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masao Koda ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Kenichiro Sakai ◽  
Kazuo Kusano ◽  
...  
Keyword(s):  
Neck Pain ◽  
Positive Association ◽  
Posterior Longitudinal Ligament ◽  
Neurological Recovery ◽  
Stepwise Logistic Regression ◽  
Significant Positive Association ◽  
Cervical Spine Surgery ◽  
Neurological Improvement ◽  
Significant Difference ◽  
Univariate Analyses

AbstractAlthough favourable surgical outcomes for myelopathy caused by cervical ossification of the posterior longitudinal ligament (OPLL) have been reported, factors significantly associated with post-operative neck pain attenuation still remain unclear. The primary aim of the present study was to determine factors significantly associated with post-operative neck pain attenuation in patients with cervical OPLL using a prospective multi-centre registry of surgically treated cervical OPLL. Significant postoperative neck pain reduction (50% reduction of neck pain) was achieved in 31.3% of patients. There was no significant difference in neck pain attenuation between surgical procedures. Statistical analyses with univariate analyses followed by stepwise logistic regression revealed neurological recovery as a factor having a significant positive association with post-operative neck pain attenuation (p = 0.04, odds ratio 5.68 (95% confidence interval: 1.27–22.2)). In conclusion, neurological recovery was an independent factor having a significant positive association with post-operative neck pain attenuation in patients with cervical myelopathy caused by OPLL who underwent cervical spine surgery.

A rare case of cervical myelopathy caused by invaginated laminae of the axis into the spinal canal

2016 ◽  
Vol 16 (9) ◽  
pp. e599-e600 ◽  
Author(s):  
Ce Zhu ◽  
Bangjian Zhou ◽  
Limin Liu ◽  
Yueming Song
Keyword(s):  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Rare Case

Spinal Epidural Compression Secondary to Osteoblastic Metastatic Vertebral Expansion

Neurosurgery ◽  
1988 ◽  
Vol 23 (5) ◽  
pp. 662-665 ◽  
Author(s):  
Alan Hirschfeld ◽  
William Beutler ◽  
Juliet Seigle ◽  
Herbert Manz
Keyword(s):  
Computed Tomography ◽  
Radiation Therapy ◽  
Spinal Canal ◽  
Surgical Decompression ◽  
The Other ◽  
Precise Nature ◽  
Osteoblastic Metastasis ◽  
Neurological Improvement ◽  
Epidural Compression ◽  
Spinal Epidural

Abstract We present two cases in which spinal epidural compression was caused by the expansion of bony elements into the spinal canal as a result of osteoblastic metastases. The precise nature of the compression was appreciated only on computed tomography. One patient had immediate and sustained neurological improvement after laminectomy. The other benefited temporarily, but widespread involvement of his spine ultimately led to paraplegia despite two more decompressive procedures. We think that bony expansion of the spine secondary to osteoblastic metastasis is not reversible with radiation therapy alone and is, therefore, an absolute indication for surgical decompression.

scholarly journals Effect of preservation of the C-6 spinous process and its paraspinal muscular attachment on the prevention of postoperative axial neck pain in C3–6 laminoplasty

2015 ◽  
Vol 22 (3) ◽  
pp. 221-229 ◽  
Author(s):  
Eiji Mori ◽  
Takayoshi Ueta ◽  
Takeshi Maeda ◽  
Itaru Yugué ◽  
Osamu Kawano ◽  
...  
Keyword(s):  
Neck Pain ◽  
Spinous Process ◽  
Posterior Longitudinal Ligament ◽  
Paraspinal Muscle ◽  
Vas Scores ◽  
The Mean ◽  
Axial Neck Pain ◽  
Process Length ◽  
Preservation Technique

OBJECT Axial neck pain after C3–6 laminoplasty has been reported to be significantly lesser than that after C3–7 laminoplasty because of the preservation of the C-7 spinous process and the attachment of nuchal muscles such as the trapezius and rhomboideus minor, which are connected to the scapula. The C-6 spinous process is the second longest spinous process after that of C-7, and it serves as an attachment point for these muscles. The effect of preserving the C-6 spinous process and its muscular attachment, in addition to preservation of the C-7 spinous process, on the prevention of axial neck pain is not well understood. The purpose of the current study was to clarify whether preservation of the paraspinal muscles of the C-6 spinous process reduces postoperative axial neck pain compared to that after using nonpreservation techniques. METHODS The authors studied 60 patients who underwent C3–6 double-door laminoplasty for the treatment of cervical spondylotic myelopathy or cervical ossification of the posterior longitudinal ligament; the minimum follow-up period was 1 year. Twenty-five patients underwent a C-6 paraspinal muscle preservation technique, and 35 underwent a C-6 nonpreservation technique. A visual analog scale (VAS) and VAS grading (Grades I–IV) were used to assess axial neck pain 1–3 months after surgery and at the final follow-up examination. Axial neck pain was classified as being 1 of 5 types, and its location was divided into 5 areas. The potential correlation between the C-6/C-7 spinous process length ratio and axial neck pain was examined. RESULTS The mean VAS scores (± SD) for axial neck pain were comparable between the C6-preservation group and the C6-nonpreservation group in both the early and late postoperative stages (4.1 ± 3.1 vs 4.0 ± 3.2 and 3.8 ± 2.9 vs 3.6 ± 3.0, respectively). The distribution of VAS grades was comparable in the 2 groups in both postoperative stages. Stiffness was the most prevalent complaint in both groups (64.0% and 54.5%, respectively), and the suprascapular region was the most common site in both groups (60.0% and 57.1%, respectively). The types and locations of axial neck pain were also similar between the groups. The C-6/C-7 spinous process length ratios were similar in the groups, and they did not correlate with axial neck pain. The reductions of range of motion and changes in sagittal alignment after surgery were also similar. CONCLUSIONS The C-6 paraspinal muscle preservation technique was not superior to the C6-nonpreservation technique for preventing postoperative axial neck pain.

Cervical myelopathy in patients with ossification of the posterior longitudinal ligament

2009 ◽  
Vol 10 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Macondo Mochizuki ◽  
Atsuomi Aiba ◽  
Mitsuhiro Hashimoto ◽  
Takayuki Fujiyoshi ◽  
Masashi Yamazaki
Keyword(s):  
Spinal Cord ◽  
Conservative Treatment ◽  
Spinal Canal ◽  
Clinical Course ◽  
Posterior Longitudinal Ligament ◽  
Treated Group ◽  
Spinal Canal Stenosis ◽  
Canal Stenosis ◽  
Residual Space ◽  
Surgical Group

Object The authors assessed the clinical course in patients with a narrowed cervical spinal canal caused by ossification of the posterior longitudinal ligament (OPLL), but who have no or only mild myelopathy. Additionally, the authors analyzed the factors contributing to the development and aggravation of myelopathy in patients with OPLLinduced spinal canal stenosis. Methods Between 1997 and 2004, the authors selected treatments for patients with cervical OPLL in whom the residual space available for the spinal cord was ≤ 12 mm. Treatment decisions were based on the severity of myelopathy at presentation. Twenty-one patients with no or mild myelopathy (defined as a Japanese Orthopaedic Association [JOA] scale score ≥ 14 points) received conservative treatment, with a mean follow-up period of 4.5 years. In 20 patients with moderate or severe myelopathy (JOA scale score < 14 points), the authors performed surgery via an anterior approach. The clinical course in these patients was assessed with the JOA scale and the OPLL types were classified. The authors evaluated the range of motion between C-1 and C-7, the developmental segmental sagittal diameter, the percentage of spinal canal diameter occupied by the OPLL (% ratio), and the residual space available for the spinal cord on cervical radiographs; T2-weighted MR images were examined for high signal changes (HSCs). Results In the conservative treatment group, 8 patients showed improvement, 12 remained unchanged, and 1 patient's condition became slightly worse during the observation period. Fifteen patients in this group had mixedtype, 3 had continuous-type, 2 had localized-type, and 1 had a segmental-type OPLL. In the surgically treated group, there were 12 patients with segmental-type, 10 patients with mixed-type, and 1 with localized-type OPLL. The mean range of motion at C1–7 was 36.4° in the conservatively treated group and 46.5° in the surgical group (p < 0.05). No significant difference was seen between the groups in terms of developmental segmental sagittal diameter, % ratio, or residual space available for the cord. No HSCs were noted in the conservative group, while 17 patients in the surgical group had HSCs (p < 0.05). Conclusions In the present study, the authors demonstrate that the mobility of the cervical spine and the type of OPLL are important factors contributing to the development and aggravation of myelopathy in patients with OPLLinduced spinal canal stenosis. The authors advocate conservative treatment in most patients with OPLLs who have no or only mild myelopathy, even in the presence of spinal canal narrowing.

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