Objective: The indications for treating cervical spondylotic myelopathy (CSM) with laminectomy and instrumented fusion remain ill-defined. Cervical laminectomy without instrumented fusion has been associated with suboptimal outcomes, particularly in the setting of cervical kyphosis. This work's purpose is to retrospectively review our experience in patients who underwent laminectomy with instrumented fusion for CSM and to assess the neurological and radiological outcomes of patients treated with this technique.
Methods: Fifty-four consecutive patients underwent multilevel laminectomy and instrumented fusion for CSM. The indications were patients with (1) cervical stenosis > or = 3 spinal segments and (2) absence of a cervical kyphosis or (3) patients older than 65 years with significant medical comorbidities. Nurick myelopathy grades and cervical radiographs were obtained preoperatively and at 3, 6, 12 and 24 months post-operatively. Perioperative complications, radiographic and clinical outcomes were assessed and reported in this paper.
Results: Forty-four (81%) of patients showed improvement in Nurick grade after surgery by a mean of 17 months. Ten patients (19%) demonstrated stable but unimproved myelopathy. Increasing pre-operative Nurick grade was associated with an improved post-operative outcome (p<0.02). Increasing duration of pre-operative myelopathy was associated with a decreased likelihood of myelopathy improvement (p<0.001).
Discussion: Multilevel cervical laminectomy with instrumented fusion for patients with CSM resulted in an improvement in myelopathy in the majority of cases. Efficacy was similar for patients who may not have tolerated an anterior decompression, such as elderly patients with significant medical comorbidities. Hardware-related complication rates were relatively low.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1179/174313209X383277 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Brown-Séquard syndrome after blunt cervical spine trauma in a patient with preinjury multilevel hemilaminectomies and OPLL: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
Background: Brown-Séquard syndrome (BSS) is a rare neurological condition characterized by injury to one-half of the spinal cord. In the context of trauma, BSS is typically seen with penetrating injuries. Here, the authors present the unique case of a patient presenting with BSS after blunt trauma.
View Article and Find Full Text PDFRobotic-Assisted Decompression, Decortication, and Instrumentation for Minimally Invasive Transforaminal Lumbar Interbody Fusion.
JBJS Essent Surg Tech
December 2024
Department of Spine Surgery, Hospital for Special Surgery, New York, NY.
Article Synopsis
- Robotic-assisted spine surgery enhances the precision and safety of procedures like pedicle screw placement, minimizing blood loss and reducing hospital stays while alleviating postoperative pain.
- Recent advancements allow robotic systems to perform not only screw insertion but also critical tasks like surgical decompression and bone preparation, transitioning from experimental models to actual human applications.
- The Mazor X Stealth Edition Spine Robotic System facilitates these procedures by combining advanced software for planning and real-time imaging, leading to more efficient and accurate minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).
Accuracy and safety evaluation of a novel artificial intelligence-based robotic system for autonomous spinal posterior decompression.
Neurosurg Focus
December 2024
1Department of Orthopaedics, Peking University Third Hospital.
Objective: This study aimed to introduce a novel artificial intelligence (AI)-based robotic system for autonomous planning of spinal posterior decompression and verify its accuracy through a cadaveric model.
Methods: Seventeen vertebrae from 3 cadavers were included in the study. Three thoracic vertebrae (T9-11) and 3 lumbar vertebrae (L3-5) were selected from each cadaver.
Successful Rectification of Cervical Nerve Root Irritation with Sequential Surgical Maneuvers during Posterior Cervical Instrumentation.
Asian J Neurosurg
December 2024
Department of Neurosurgery and Spine Surgery, International Institute of Neurosciences, Aster Whitefield Hospital, Bengaluru, Karnataka, India.
Posterior cervical instrumentation is used to treat a variety of cervical pathologies, including cervical spondylotic myelopathy, severe canal stenosis, and degenerative diseases. A 55-year-old man with severe cervical canal stenosis underwent a C3-C6 laminectomy and lateral mass screw fixation under general anesthesia. After lateral mass screw fixation and rod placement on the right side, raw electromyography (EMG) revealed irritative discharges in the right biceps brachii muscle.
View Article and Find Full Text PDFEffects of two posterior procedures for treatment of cervical hyperextension injury with multilevel spinal stenosis: A retrospective study.
BMC Musculoskelet Disord
November 2024
Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
Background: Cervical hyperextension injuries (CHI), commonly resulting in central cord syndrome and spinal instability, often affect the elderly with preexisting degenerative spinal changes, leading to a need for surgical interventions that address both the compression and stability of the cervical spine. This study compares the clinical outcomes of two posterior decompression and fixation procedures for treating cervical hyperextension injury in patients with preexisting multilevel spinal canal stenosis.
Methods: Patients suffering from cervical hyperextension injury combined with multilevel spinal stenosis were divided into two groups.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!