scholarly journals Open-Door Laminoplasty Using Lateral Mass Anchoring Screws and Nonabsorbable Sutures in Patients with Multilevel Cervical Myelopathy

2020 ◽  
Vol 12 (4) ◽  
pp. 477
Author(s):  
Jae-Ryong Cha ◽  
Han Wook Kim ◽  
Doo Guen Yang ◽  
Hee-Yoon Chung ◽  
Il-Yeong Hwang
Keyword(s):  
Cervical Myelopathy ◽  
Lateral Mass ◽  
Open Door ◽  
Multilevel Cervical Myelopathy

scholarly journals Comparative Effectiveness and Functional Outcome of Open-Door versus French-Door Laminoplasty for Multilevel Cervical Myelopathy: A Meta-Analysis

2019 ◽  
Vol 7 (19) ◽  
pp. 3348-3352
Author(s):  
I Gusti Lanang Ngurah Agung Artha Wiguna ◽  
Rahadyan Magetsari ◽  
Zairin Noor ◽  
Suyitno Suyitno ◽  
Ricvan Dana Nindrea
Keyword(s):  
Functional Outcome ◽  
Cervical Myelopathy ◽  
Comparative Effectiveness ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Open Door ◽  
Weighted Mean ◽  
Significant Difference ◽  
Multilevel Cervical Myelopathy

BACKGROUND: At present, few reports are comparing these 2 major cervical posterior laminoplasty methods with Open-door and French-door Laminoplasty in terms of neurological recovery, cervical alignment, and surgical complications. Moreover, most of the research has not been well designed. AIM: This study aims to determine comparative effectiveness and functional outcome of open-door versus french-door laminoplasty for multilevel cervical myelopathy. METHODS: The Meta-analysis is used in this study. The study sample is a published research articles on comparative effectiveness and functional outcome of open-door versus french-door laminoplasty for multilevel cervical myelopathy on the internet through databases on PubMed and ProQuest and published between 1997 until December 2018. Weighted mean difference and pooled weighted mean difference are calculated by using the fixed-effect model or random-effect model. Data is processed by using Review Manager 5.3 (RevMan 5.3). RESULTS: This study reviews 58 articles. There are 6 studies conducted a systematic review and continued with Meta-analysis of relevant data. The results showed significant higher postoperative Japanese Orthopaedic Association (JOA) score in open-door laminoplasty (ODL) than French-door laminoplasty (FDL) (weighted mean difference [WMD] = 0.71; 95% confidence interval [CI]: 0.35 to 1.07; p < 0.05). The outcome of procedures treatment of multilevel cervical myelopathy revealed the operative time, cervical range of motion, axial canal diameter postoperative, axial pain reduction and complications events in ODL and FDL there was no significant difference. But for a cervical lordotic angle in ODL and FDL, there was a significant difference; the ODL group were significantly lesser than the FDL group. The recovery rate in ODL and FDL, there was a significant difference; the ODL was shown to be significantly higher than FDL (p < 0.05). CONCLUSION: This analysis suggests that neither cervical laminoplasty approach is superior, based on the postoperative radiological data and complication rate. But the open-door laminoplasty resulted in a higher functional outcome and recovery rate as compared to the French-door laminoplasty.

Surgical Treatment of Multilevel Degenerative Cervical Myelopathy: Open-Door Laminoplasty and Fixation via Unilateral Approach. A Feasibility Study

2021 ◽  
Author(s):  
Gregor Schmeiser ◽  
Janina Isabel Bergmann ◽  
Luca Papavero ◽  
Ralph Kothe
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Screw Fixation ◽  
Lateral Mass ◽  
Open Door ◽  
Lateral Mass Screw ◽  
Unilateral Approach ◽  
The Mean ◽  
Degenerative Cervical Myelopathy

Abstract Objective We compared open-door laminoplasty via a unilateral approach and additional unilateral lateral mass screw fixation (uLP) with laminectomy and bilateral lateral mass screw fixation (LC) in the surgical treatment of multilevel degenerative cervical myelopathy (mDCM). Methods A retrospective cohort analysis of 46 prospectively enrolled patients (23 uLP and 23 LC). The minimum follow-up was 1 year. Neck and arm pains were evaluated with visual analog scales and disability with the Neck Disability Index (NDI). Myelopathy was rated with the modified Japanese Orthopaedic Association (mJOA) score. Cervical sagittal parameters were measured on plain and functional X-ray films with a specific software. The statistical significance was set at p < 0.05. Fusion was defined as <2 degrees of intersegmental motion on flexion/extension radiographs. Results The two groups were similar in age and comorbidities. The mean operation time and the mean hospital stay were shorter in the uLP group (p = 0.015). The intraoperative blood loss did not exceed 200 mL in both groups. At follow-up, the groups showed comparable clinical outcome data. The sagittal profile did not deteriorate in either group. Fusion rates were 67% in the uLP group and 92% in the LC group. No infections occurred in either group. In the LC group, one patient developed a transient C5 palsy. Revision surgery was required for a malpositioned screw (LC) and for one implant failure (uLP). Conclusion Laminoplasty and unilateral fixation via a unilateral approach achieved comparable clinical and radiologic results with laminectomy and bilateral fixation, despite a lower fusion rate. However, the surgical traumatization was less.

scholarly journals Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: a case‐control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lin Du ◽  
Yanzheng Gao ◽  
Changqing Zhao ◽  
Tangjun Zhou ◽  
Haijun Tian ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Cervical Myelopathy ◽  
Case Control Study ◽  
Case Control ◽  
Axial Symptom ◽  
Segmental Instability ◽  
Neurologic Status ◽  
Multilevel Cervical Myelopathy ◽  
Control Study

Abstract Background Segmental cervical instability is a risk factor for the progression of osteophytic bone spurs and development of myelopathy, and is treated as a relative contraindication of cervical laminoplasty. The aim of this study was to compare laminoplasty with selective fixation (LPSF) versus laminectomy with fusion (LCF) in patients with multilevel cervical myelopathy accompanied by segmental instability. Methods A case-control study was conducted by reviewing data from 63 patients who underwent LPSF (n = 30) or LCF (n = 33). Cervical alignment, range of motion (ROM), neurologic status and axial symptom severity pre-operation, 3-days after operation, and at the final follow-up (minimum 24 months) were measured and compared between groups. Results Postoperation, patients in the LPSF group lost 31.1 ± 17.3 % of cervical lordosis and 43.2 ± 10.9 % cervical ROM while patients in the LCF group lost 5.7 ± 8.2 % and 67.9 ± 15.5 %, respectively. Both LPSF and LCF groups significantly improved neurologic status and axial symptom severity at the final follow-up with similar between-group results(P > 0.05). Blood loss, operation time, hospital stay, and medical cost in the LPSF group were significantly less than in the LCF group(P < 0.05). Conclusions In 2 years of clinical observation, LPSF was effective in maintaining the stability of the cervical spine with less sacrifice of mobility and surgical trauma for multilevel myelopathy with segmental instability compared to LCF.

OPEN-DOOR EXPANSILE CERVICAL LAMINOPLASTY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-154-S1-159 ◽  
Author(s):  
Elizabeth Vitarbo ◽  
Rishi N. Sheth ◽  
Allan D. Levi
Keyword(s):  
Surgical Technique ◽  
Spinal Stenosis ◽  
Cervical Myelopathy ◽  
Outcome Data ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Cervical Spinal Stenosis ◽  
Current Article

Abstract OPEN-DOOR EXPANSILE laminoplasty is a practical surgical technique for the treatment of cervical myelopathy secondary to cervical spinal stenosis. Laminoplasty procedures were first described in the late 1970s and have undergone numerous modifications. The current article reviews the indications, techniques, and outcome data for cervical laminoplasty. Complications of laminoplasty and comparison to laminectomy outcomes are also discussed.

scholarly journals Modified Open-Door Laminoplasty Using a Ceramic Spacer and Suture Fixation for Cervical Myelopathy

2015 ◽  
Vol 56 (6) ◽  
pp. 1651 ◽  
Author(s):  
Tomoyuki Ozawa ◽  
Tomoaki Toyone ◽  
Ryutaro Shiboi ◽  
Kunimasa Inada ◽  
Yasuhiro Oikawa ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Suture Fixation ◽  
Open Door

Vertical translocation: the enigma of the disappearing atlantodens interval in patients with myelopathy and rheumatoid arthritis. Part I. Clinical, radiological, and neuropathological features

1997 ◽  
Vol 87 (6) ◽  
pp. 856-862 ◽  
Author(s):  
Adrian T. H. Casey ◽  
H. Alan Crockard ◽  
Jennian F. Geddes ◽  
John Stevens
Keyword(s):  
Cervical Myelopathy ◽  
Survival Rates ◽  
Cord Compression ◽  
Atlantoaxial Subluxation ◽  
Lateral Mass ◽  
Progressive Decrease ◽  
Content Type ◽  
Statistical Comparison ◽  
High Cervical ◽  
Fine Print

✓ This statistical comparison between patients with cervical myelopathy secondary to horizontal atlantoaxial subluxation and those with vertical translocation is designed to elucidate the mechanisms responsible for cranial settling and the effect of translocation on the development of spinal cord compression. In a 10-year study of a cohort of 256 patients, 186 suffered from myelopathy and 116 (62%) of these exhibited vertical translocation according to the Redlund-Johnell criteria. Vertical translocation occurred after a significantly longer period of disease than atlantoaxial subluxation (p < 0.001). Translocation was characterized clinically by a high cervical myelopathy with features of a cruciate paralysis present in 35% of individuals compared with 26% who exhibited horizontal atlantoaxial subluxation (p = 0.29), but there was a surprising paucity of cranial nerve problems. The patients with vertical translocation had a greater degree of neurological disability (p = 0.002) and poorer survival rates (p = 0.04). Radiologically, vertical translocation was secondary to lateral mass collapse and associated with a progressive decrease in the atlantodens interval ([ADI], r = 0.4; p < 0.001) and pannus (p = 0.003). Thirty percent of patients exhibited an ADI of less than 5 mm. This phenomenon has been termed pseudostabilization. The authors' studies emphasize that the ADI (frequently featured in the literature) is totally unreliable as an indicator of neuraxial compromise in the presence of vertical translocation.

scholarly journals Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: A retrospective comparative study

2019 ◽  
Author(s):  
Lin Du ◽  
Yanzheng Gao ◽  
Changqing Zhao ◽  
Tangjun Zhou ◽  
Haijun Tian ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Cervical Myelopathy ◽  
Operation Time ◽  
Surgical Trauma ◽  
Axial Symptom ◽  
Neurologic Status ◽  
Selective Fusion ◽  
Retrospective Comparative Study ◽  
Multilevel Cervical Myelopathy

Abstract Purpose The aim of this study was to compare laminoplasty with selective fixation (LPSF) versus laminectomy with fusion (LCF) in patients with multilevel cervical myelopathy accompanied by segmental instability.Methods A retrospective cohort study was conducted by reviewing data from 63 patients who underwent LPSF (n=30) or LCF (n=33). Cervical alignment, range of motion (ROM), neurologic status and axial symptom severity pre-operation, 3-days after operation, and at the final follow-up (minimum 24 months) were measured and compared between groups.Results Postoperation, patients in the LPSF group lost 31.1±17.3% of cervical lordosis and 43.2±10.9% cervical ROM while patients in the LCF group lost 5.7±8.2% and 67.9±15.5%, respectively. Both LPSF and LCF groups significantly improved neurologic status and axial symptom severity at the final follow-up with similar between-group results(P>0.05). Blood loss, operation time, hospital stay, and medical cost in the LPSF group were significantly less than in the LCF group(P<0.05). The incidence of negative events were statistically similar between groups.Conclusion According to our results, LPSF was effective in maintaining the stability of the cervical spine with less sacrifice of mobility and surgical trauma for multilevel myelopathy with segmental instability compared to LCF.

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