Outcome of Laminoplasty in Patients with Multilevel Cervical Myelopathy

Authors

  • FAIQ SHEIKH Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences (PINS), Lahore General Hospital (
  • FAHEEM AHMAD USMANI Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences (PINS), Lahore General Hospital
  • ADNAN KHALID 1Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences (PINS), Lahore General Hospital
  • TARIQ SALAHUDDIN National Hospital & Medical Care,
  • JAMAL NASIR Children Hospital, Lahore – Pakistan

DOI:

https://doi.org/10.36552/pjns.v23i3.361

Keywords:

Myelopathy, Laminoplasty, degenerative cervical spine, JOA score

Abstract

Objective: To determine the outcome of surgical intervention in the form of laminoplasty in the patients with multilevel cervical myelopathy.
Material and Methods: Descriptive case series, was conducted at NS-I, PINS, Lahore for 6 months. The patients were included through non probability consecutive sampling that fulfilled inclusion criteria. All of the patients were assessed using JOA score before and after 2 months of surgery. General characteristics, including age, gender, other medical conditions and other risk factors were assessed prior to surgery. The total number of 35 patients was included with expected JOA percentage recovery rate of 75% + 21% after the procedure.
Results: In this study 35 total patients were enrolled. The mean age was 55.68 + 9.92 years. Total number of male patients were 23 (65.71), while the female was 12 (34.29). The mean duration of degenerative cervical myelopathy was 3.90 + 1.3 months. The mean pre op value of JOA score was 7.08 + 2.7 (4 – 10) for the patients. The mean post op score was 13.00 + 2.30 (9 – 17). The mean recovery value calculated at two month interval was 62.12 + 17.39 (38.46 – 100). Statistically, there was a significant difference of outcome of pre and post op value of JOA scores i.e., p value = 0.00.
Conclusion: Our study determined that, the open door laminoplasty is an effective and reliable technique with good outcome in the treatment of multi-level degenerative cervical spine myelopathy patients. 

References

Paul C. McCormick, Michael G. Kaiser, Peter D. Angevine, Alfred T. Ogden, Mandigo CE, Reid PC. Cervical Spondylotic Myelopathy. 2019.
https://www.columbiaspine.org/condition/cervical-spondylotic-myelopathy/2019).
2. Arantes Júnior AA, Silva Junior GAd, Malheiros JA, et al. A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results. Arquivos de neuro-psiquiatria. 2014; 72 (1): 49-54.
3. NHS. Cervical spondylosis. 2017.
4.Lao L, Zhong G, Li X, Qian L, Liu Z. Laminoplasty versus laminectomy for multi-level cervical spondylotic myelopathy: a systematic review of the literature. Journal of orthopaedic surgery and research, 2013; 8 (1): 45.
5. Shunzhi Y, Zhonghai L, Fengning L, Zhi C, Tiesheng H. Surgical management of 4-level cervical spondylotic myelopathy. Orthopedics, 2013; 36 (5): e613-e20.
6. Oe K, Doita M, Miyamoto H, Kanda F, Kurosaka M, Sumi M. Is extensive cervical laminoplasty an effective treatment for spinal cord sarcoidosis combined with cervical spondylosis? European Spine Journal, 2009; 18 (4): 570-6.
7. Matz PG, Anderson PA, Groff MW, et al. Cervical laminoplasty for the treatment of cervical degenerative myelopathy. Journal of Neurosurgery: Spine, 2009; 11 (2): 157-69.
8. Singh K, Vaccaro AR. Pocket atlas of spine surgery: Thieme; 2018.
9. Yuan X, Wei C, Xu W, Gan X, Cao S, Luo J. Comparison of laminectomy and fusion vs laminoplasty in the treatment of multilevel cervical spondylotic myelopathy: A meta-analysis. Medicine, 2019; 98 (13).
10. Li X-K, Liu X, Che L, Ma C-J, Samartzis D, Wang H-Q. Cervical open-door laminoplasty technique with simple sutures and bone grafts: a single institutional study with 30 consecutive cases. Journal of orthopaedic surgery and research, 2015; 10 (1): 14.
11. Bratcher K, Brock D, Glassman SD, Campbell MJ, Carreon LY. Instrumented open-door laminoplasty as treatment for cervical myelopathy in 104 patients. American journal of orthopedics (Belle Mead, NJ) 2009; 38 (7): E123-8.
12. Oki S, Matsuda Y, Shibata T, Okumura H, Desaki J. Morphologic differences of the vascular buds in the vertebral endplate: scanning electron microscopic study. Spine, 1996; 21 (2): 174-7.
13. Tanaka N, Nakanishi K, Fujimoto Y, et al. Expansive laminoplasty for cervical myelopathy with interconnected porous calcium hydroxyapatite ceramic spacers: comparison with autogenous bone spacers. Clinical Spine Surgery, 2008; 21 (8): 547-52.

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Published

2019-09-27

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Original Articles