Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy
| Autor: | Seishi Matsui, Yoshihisa Oka, Yoshiaki Kumon, Kanehisa Kohno, Saburo Sakaki, Shiro Ohue |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Spinal stenosis medicine.medical_treatment Spondylolysis Spinal canal stenosis Ossification of Posterior Longitudinal Ligament Myelopathy Spinal Stenosis Predictive Value of Tests Risk Factors medicine Humans Posterior longitudinal ligament Cervical canal Aged business.industry Laminectomy Middle Aged Prognosis Laminoplasty medicine.disease Magnetic Resonance Imaging Surgery Radiography Treatment Outcome medicine.anatomical_structure Female Neurology (clinical) business Neck Follow-Up Studies |
| Zdroj: | Surgical Neurology. 48:237-245 |
| ISSN: | 0090-3019 |
| DOI: | 10.1016/s0090-3019(97)00166-3 |
| Popis: | Background Expansive laminoplasty of several types has been proposed for patients with cervical multisegmental stenotic myelopathy to reduce postlaminectomy complications. Its effectiveness has not been fully explored by evaluating long-term results and magnetic resonance imaging (MRI) findings before and after surgery. Methods We conducted a 5-year follow-up study of 22 patients with cervical spondylotic myelopathy and/or ossification of the posterior longitudinal ligament surgically treated with expansive laminoplasty. The operative results were examined using the Japanese Orthopedic Association (JOA) disability scale, with reference to the findings of MRI, computed tomography, and radiography. Results Postoperative improvement was observed in 18 (81.8%) of the 22 patients. In 11 patients the percentage recovery of the JOA score was higher than 50% (average: 83.1%), while in the remaining 11 patients it was lower than 50% (average: 20.1%). Factors contributing to incomplete recovery appear to be related mainly to cord degeneration with atrophy (depicted as a T2-high intensity area) and to specific factors such as long symptom duration, age higher than 70 years, deterioration due to trauma, severe cord compression, radiculopathy, and kyphotic cervical curvature. Conclusions In cervical myelopathy, patients with multisegmental stenosis, expansive laminoplasty can be expected to provide a favorable outcome by providing sufficient cord decompression and stabilization of the cervical spine, when the stenotic cervical canal is enlarged to the normal range (over 12 mm residual anteroposterior diameter and 200 mm2 residual canal area). The efficacy can be restricted by various factors, especially irreparable cord degeneration. |
| Databáze: | OpenAIRE |
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