MINIMALLY INVASIVE SINGLE-DOOR PLATE LAMINOPLASTY WITH LATERAL MASS SCREW FIXATION FOR THE UNSTABLE SEGMENT. REPORT OF TWO CASES WITH LONG FOLLOW-UP
| Autor: | Sergio Soriano-Solis, José-Antonio Soriano-Sánchez, Héctor Antonio Soriano Solís, Manuel Rodríguez-García, Javier Quillo-Olvera |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system Visual analogue scale Espondilose medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Medicine Procedimentos cirúrgicos minimamente invasivos Orthopedics and Sports Medicine Contraindication 030222 orthopedics Neck pain business.industry Vértebras cervicais Laminectomy Laminoplasty medicine.disease Surgery Oswestry Disability Index Doenças da medula espinal lcsh:RD701-811 medicine.anatomical_structure Laminectomia Radicular pain Neurology (clinical) lcsh:RC925-935 medicine.symptom business 030217 neurology & neurosurgery Cervical vertebrae |
| Zdroj: | Coluna/Columna, Vol 16, Iss 3, Pp 236-239 |
| ISSN: | 1808-1851 |
| Popis: | Background. CL is an option for the treatment of patients with multileve CSM. Segmental unstability is theoretically an absolute contraindication for performing a laminoplasty. In those cases, to our knowledge there are no reports of minimally invasive surgery treatments. Objective. To report two cases of multilevel cervical spondylotic myelopathy with mono segmental unstability in which we performed a minimally invasive microsurgical transmuscular approach with tubular retractors for making a single-door plate laminoplasty combined with fixation of the unstable segment with lateral mass screws. Patients and Methods. Surgical procedures were done by the senior author. In both patients the follow up was done using Oswestry Disability Index (ODI), Visual Analogue Scale for neck and radicular pain (radVAS, neckVAS), Neck Disability Index (NDI) and Short Form 36 (SF-36) in the preoperative (preop) and postoperative (postop) at 1,3,6,12,18 and 24 months. A radiological evaluation also was done including AP, lateral and flexion-extension films at 6, 12 and 24 months and CT-scan at 12 months. Results. Case 1 - preop ODI: 40%, 24 months postopODI: 4%; preop radVAS: 7, 24m radVAS: 0; preop neckVAS: 8, postop 24 months neckVAS: 0; preopNDI: 43%, 24 months PostopNDI: 8% SF-36 - preop Physical Functioning (PF): 40, preop Vitality (VT): 40, preop Emotional role functioning (RE): 33.3, Bodily pain (BP): 51, General Health (GH): 57, Social Functioning (SF): 75; postop PF: 95, VT: 95, RE: 100, BP: 74, GH: 87, SF: 100. Case 2 - preopODI: 46%, 24months postopODI: 10%; preop radVAS: 7, 24m radVAS: 0; preop neckVAS: 9, postop 24 months neckVAS: 0; preopNDI: 56%, 24 months PostopNDI: 15%. SF-36 - preop PF: 39, VT: 45, RE: 33.3, BP: 50, GH: 49, SF: 70; postop PF: 90, VT: 100, RE: 100, BP: 82, GH: 87, SF: 100. No complications, cervical unstability or signs of failed surgery were found trough and at final follow up at 24 months. We found significant clinical improvement in both patients. Conclusion. Minimally invasive cervical laminoplasty combined with lateral mass screw fixation for the unstable segment is a useful technique in cases with multilevel cervical spondylotic myelopathy associated with monosegmentary unstability. Additional comparative studies are needed for stablishing it’s efficacy. Abbreviations. CL – Cervical Laminoplasty. SCM – Cervical Spondylotic Myelopathy. NDI – Neck Disability Index. neckVAS – neck pain Visual Analogue Scale. ODI – Oswestry Disability Index. radVAS – radicular pain Visual Analogue Scale. SF-36 – Short Form 36. |
| Databáze: | OpenAIRE |
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