Study Design: Retrospective analysis.
Purpose: To compare results of laminectomy in multisegmental compressive cervical myelopathy (CSM) with lordosis versus segmental kyphosis.
Overview Of Literature: Laminectomy is an established procedure for decompression in CSM with cervical lordosis. However in patients with segmental kyphosis, it is associated with risk of progression of kyphosis and poor outcome. Whether this loss of sagittal alignment affects functional outcome is not clear.
Methods: We retrospectively reviewed 68 patients who underwent laminectomy for CSM from 1998 to 2009. As per preoperative magnetic resonance images, 36 patients had preoperative lordosis (Group 1) and 32 had segmental kyphosis (Group 2). We studied age at the time of surgery, duration of preoperative symptoms, recovery rate, magnitude of postoperative backward shifting of spinal cord and loss of sagittal alignment.
Results: Mean follow up was 5.05 years (range, 2-13 years) and mean age at the time of surgery 61.88 years. Group 1 had 20 men and 16 women and Group 2 had 19 men and 13 women. Mean recovery rate in Group 1 was 60.32%, in Group 2 was 63.7% without any statistical difference (-value 0.21, one tailed analysis of variance). Two patients of Group 1 had loss of cervical lordosis by five degrees. In Group 2 seven patients had progression of segmental kyphosis by 5-10 degrees and two patients by more than 10 degrees. Mean cord shift was more in Group 1 (mean, 2.41 mm) as compared to Group 2 (mean, -1.97 mm) but it had no correlation to recovery rate. Patients with younger age (mean, 57 years) and less duration of preoperative symptoms (mean, 4.86 years) had better recovery rate (75%).
Conclusions: Clinical outcome in CSM is not related to preoperative cervical spine alignment. Thus, lordosis is not mandatory for planning laminectomy in CSM. Good outcome is expected in younger patients operated earliest after onset of symptoms.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326727 | PMC |
| http://dx.doi.org/10.4184/asj.2017.11.1.24 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The effect of degenerative scolioisis on segmental thoracolumbar sagittal alignment compared to age- and pelvic incidence-matched reference values.
Eur Spine J
January 2025
Service de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1 Avenue Molière, Strasbourg, France.
Introduction: In asymptomatic subjects, variations of sagittal alignment parameters according to age and pelvic incidence (PI) has been reported. The aim of this observational study was to describe thoraco-lumbar sagittal alignment in patients with degenerative scoliosis and to compare them to asymptomatic individuals, seeking for the specific effect of deformity in similar age and PI groups.
Materials And Methods: Full spine radiographs of 235 asymptomatic subjects and 243 scoliosis patients were analyzed: cervico-thoracic inflexion point (CTIP), thoraco-lumbar inflexion point (TLIP), lumbar lordosis (LL) L1-S1, LL (TLIP-S1), LL superior arch (TLIP-lumbar apex), LL inferior arch (lumbar apex-S1), PI, thoracic kyphosis (TK) T5-T12, TK T1-T12, number of vertebrae CTIP-TLIPandTLIP-S1.
Keyhole decompression surgery for holospinal epidural abscess: a novel approach for spinal stability preservation.
Eur Spine J
January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Purpose: Spinal epidural abscesses are rare yet serious conditions, often necessitating emergency surgical intervention. Holospinal epidural abscesses (HEA) extending from the cervical to the lumbosacral spine are even rarer and present significant challenges in management. This report aims to describe a case of HEA with both ventrally-located cervical and dorsally-located thoracolumbar epidural abscesses treated with a combination of anterior keyhole decompression and posterior skip decompression surgeries.
View Article and Find Full Text PDFThe Predictive Value of Multifidus Degeneration in Osteoporotic Vertebral Compression Fracture Patients with Kyphosis Deformity.
Spine J
January 2025
Orthopedic Department, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, 49 North Garden Road, Haidian District, Beijing 100191, China; Beijing Key Laboratory of Spinal Disease Research, 49 North Garden Road, Haidian District, Beijing 100191, China. Electronic address:
Background Context: Osteoporotic vertebral compression fracture (OVCF) causes pain, kyphosis and neurological damage, which significantly affect patients' quality of life. Patients with OVCF are often elderly and have severe osteoporosis, which makes preoperative symptom more serious, postoperative recovery worse and the incidence of postoperative complications high. The paraspinal muscles have been well studied in adult spinal deformities, but there is no conclusive evidence that their findings can be applied to OVCF.
View Article and Find Full Text PDFThe influence of sintering of osteoporotic vertebral fractures on the sagittal lumbar profile and degenerative changes.
J Orthop Surg Res
January 2025
Department of Orthopaedic and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
Background: Osteoporosis, a skeletal disorder affecting nearly 20% of the global population, poses a significant health concern, with osteoporotic vertebral body fractures (VBF) representing a common clinical manifestation. The impact of osteoporotic sintering fractures in the thoracolumbar spine on the sagittal lumbar profile is incompletely understood and may lead to the onset of clinical symptoms in previously asymptomatic patients.
Methods: This retrospective single-center study analyzed data from patients presenting with osteoporotic spine fractures between 2017 and 2022.
Long-Term Outcomes of Modified Expansive Open-Door Laminoplasty Combined with Short-Level Anterior Cervical Fusion in Multilevel Cervical Spondylotic Myelopathy.
Medicina (Kaunas)
December 2024
School of Medicine, Tzu Chi University, Hualien 970, Taiwan.
: Multilevel cervical spondylotic myelopathy (MCSM) presents complex challenges for surgical management, particularly in patients with kyphosis or significant anterior pathology. This study aimed to assess the long-term efficacy of modified expansive open-door laminoplasty (MEOLP) combined with short-level anterior cervical fusion (ACF) in providing decompression, preserving alignment, and maintaining range of motion (ROM) over a nine-year follow-up. : A retrospective analysis was conducted on 124 MCSM patients treated with MEOLP combined with ACF between 2011 and 2015.
View Article and Find Full Text PDFWant 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!