scholarly journals Two Types of Laminoplasty for Cervical Spondylotic Myelopathy at Multiple Levels

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Shigeru Hirabayashi ◽  
Takashi Matsushita
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Spinal Canal Stenosis ◽  
Decompression Surgery ◽  
Pathological Changes ◽  
Posterior Decompression ◽  
Element Analysis ◽  
Pathological Analysis ◽  
Canal Stenosis ◽  
Multiple Levels

Based on the results from pathological analysis and computer simulations by means of finite element analysis that were reported before, the pathological changes of cervical spondylotic myelopathy (CSM) seem to begin at the posterolateral parts of the spinal cord, because the mechanical stress is mainly concentrated in these parts. With progression of the compression, the pathological changes become distributed to a wider area of the spinal cord. In patients with spinal canal stenosis, these changes spread to multiple levels of the cervical spine. Therefore, posterior decompression surgery at multiple levels such as cervical laminoplasty is thought to be reasonable.

scholarly journals Posterior Decompression Usign METRx-MD System for Lumbar Spinal Canal Stenosis

2006 ◽  
Vol 55 (4) ◽  
pp. 467-470
Author(s):  
Masaki Yoh ◽  
Masayoshi Oga ◽  
Junichi Arima ◽  
Ko Ikuta ◽  
Soichiro Nakano ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Lumbar Spinal Canal Stenosis ◽  
Posterior Decompression ◽  
Canal Stenosis ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

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.

scholarly journals Ligamentum flavum hypertrophy in a patient with Pott’s disease

2020 ◽  
pp. 77-77
Author(s):  
Vuk Aleksic ◽  
Rosanda Ilic ◽  
Mihailo Milicevic ◽  
Filip Milisavljevic ◽  
Milos Jokovic
Keyword(s):  
Spinal Cord ◽  
Spinal Deformity ◽  
Neurological Deficit ◽  
Ligamentum Flavum ◽  
Late Onset ◽  
Spinal Canal Stenosis ◽  
Pott’S Disease ◽  
Canal Stenosis ◽  
Common Causes ◽  
Angular Kyphosis

Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is one of the most common causes for an angular kyphotic deformity of spine. Patients with 60 or more degree kyphosis at dorsolumbar spine are at great risk to develop late onset neurological deficit and paraplegia due to chronic compression and stretching of the spinal cord over bonny ridges. In small portion of cases other conditions may lead to neurological deficit in patients with long standing angular kyphosis which also alters the treatment strategy that otherwise involves prolonged and mutilant surgery. Case outline. We present a case of a 61-year-old male patient with concomitant 90-degree dorsolumbar spine kyphosis due to spinal TB and ligamentum flavum hypertrophy, which led to spinal canal stenosis with myelopathy and consequent paraplegia. The patient undergoes dorsal decompression with removal of the hypertrophic yellow ligament after which he recovered to the level of walking. Conclusion. Many authors propose guidelines for treatment of spinal TB taking into account the stage of the disease, the age of the patient, the angle of kyphosis, and other factors. We find that the best approach for each patient is personalized medical approach.

Cervical Spondylotic Myelopathy: Treatment with Posterior Decompression and Luque Rectangle Bone Fusion

Neurosurgery ◽  
1991 ◽  
Vol 28 (5) ◽  
pp. 680-684 ◽  
Author(s):  
Paul Kurt Maurer ◽  
Richard G. Ellenbogen ◽  
James Ecklund ◽  
Gary R. Simonds ◽  
Bruce van Dam ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Canal ◽  
Cervical Spondylotic Myelopathy ◽  
Substantial Evidence ◽  
Posterior Decompression ◽  
Neurological Improvement ◽  
Bone Fusion ◽  
Dynamic Factors ◽  
Dynamic Forces ◽  
Repetitive Trauma

Abstract Cervical spondylotic myelopathy appears to result from a combination of factors. The two major components are 1) compressive forces resulting from narrowing of the spinal canal, and 2) dynamic forces owing to mobility of the cervical spine. There is substantial evidence to suggest that the repetitive trauma to the spinal cord that is sustained with movement in a spondylotic canal may be a major cause of progressive myelopathy. Utilization of extensive anterior procedures that remove the diseased ventral features as well as eliminate the dynamic forces owing to the accompanying fusion have grown in popularity. Cervical laminectomy enlarges the spinal canal, but does not reduce the dynamic forces affecting the spinal cord, and may actually increase cervical mobility, leading to a perpetuation of the myelopathy. The authors propose the combination of posterior decompression and Luque rectangle bone fusion to deal with both the compressive and the dynamic factors that lead to cervical spondylotic myelopathy. Ten patients who had advanced myelopathy underwent the combined procedures. Nine of the 10 experienced significant neurological improvement, and the 10th has had no progression. The combination of posterior decompression and Luque rectangle bone fusion may offer a simple, safe, and effective alternative treatment for cervical spondylotic myelopathy.

Diabetes Does Not Adversely Affect Neurological Recovery and Reduction of Neck Pain After Posterior Decompression Surgery for Cervical Spondylotic Myelopathy

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Satoshi Nori ◽  
Narihito Nagoshi ◽  
Kenji Yoshioka ◽  
Kenya Nojiri ◽  
Yuichiro Takahashi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Spondylotic Myelopathy ◽  
Neurological Recovery ◽  
Decompression Surgery ◽  
Posterior Decompression
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