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Laminoplasty and corporectomy in the treatment of cervical spondylotic myelopathy

Ламинопластика и корпорэктомия в лечении спондилогенной шейной миелопатии
Authors: Dreval’ Maxim Dmitrievich; Arestov Sergey Olegovich; Petrosyan David Vazgenovich; Kashcheev Alexey Alexeevich; Vershinin Andrey Vyacheslavovich; Poltorako Ekaterina Nikolaevna; Gushcha Artem Olegovich;

Laminoplasty and corporectomy in the treatment of cervical spondylotic myelopathy

Abstract

Introduction: Cervical Spondylotic myelopathy (CSM) is a disabling manifestation of extended cervical stenosis characterized by pronounced neurological dysfunction. Decompressive interventions contribute to significant regression of symptoms and, in some cases, complete recovery can be achieved. Objective: To explore the potential of laminoplasty in patients with extended cervical spondylotic stenoses complicated by myelopathy, and to develop approaches for surgical intervention in these patients. Material and methods: 56 patients were included in the study. Laminoplasty was performed in 34 patients (average age, 59.4 12.8 years, women/men ratio, 9:25); 28 patients had compression on 3 levels of, 4 patients had compression on 4 levels and 2 patients had compression over 5 levels. Corporectomy was performed in 22 patients who made up the comparison group (average age, 43.8 16.4 years, women/men ratio, 7:15). The frequency and initial severity of concomitant non-neurological disorders in both groups were comparable. Results: Indications for laminoplasty were determined. They include: symptoms of spondylotic myelopathy, three or more levels of compression, preservation of lordosis, absence of segmental instability signs, inability to perform anterior decompression, and age over 55 years. The presence of segmental instability signs, kyphotic deformation and history of mental disorders may be considered as contraindications for this surgery. Early and late ( 3 years) clinical outcomes (evolution of pyramidal and sensory symptoms) and X-ray and neuroimaging postoperative parameters (spine canal width, preservation of lordosis, etc.) were evaluated. Conclusions: Due to a number of advantages, lamynoplasty is the treatment of choice for extended cervical spondylotic stenosis. Adequate selection of patients based on the evaluation of clinical symptoms, extension of stenosis, neurological signs and neuroimaging features make possible to achieve excellent results. This type of surgery is preferable for elderly patients (5560 years).

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Keywords

Orthopedic surgery, cervical spine stenosis, corporectomy, Neurosciences. Biological psychiatry. Neuropsychiatry, Estenosis espinal, Diseases of the musculoskeletal system, Fusão vertebral, Myelitis, Mielite, Laminoplasty, Fusión vertebral, Laminoplastia, RC925-935, Estenose espinal, Spinal stenosis, Mielitis, laminoplasty, Spinal fusion, RD701-811, RC321-571, cervical myelopathy

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
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Average
Average
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