A Novel Technique for Cervical Laminoplasty Fusion (CLPF) - Simultaneously Enhancing Stabilization and Decompression in Various Cervical Myelopathies: A Technical Note and Outcomes.
World Neurosurg. 2018 Jan 08;:
Authors: Kim IS, Hong JT, Lee JJ, Lee JB, Cho CB, Yang SH, Sung JH
Abstract
PURPOSE: Cervical laminectomy has two major disadvantages: post-laminectomy adhesion of dural membrane and the lack of a fusion bed. The objective of this study was to determine whether simultaneous laminoplasty with fusion (CLPF) might overcome these unwanted outcomes.
METHODS: Cases of CLPF for treating various cervical myelopathy with instability who were followed up for at least 12 months were enrolled. Preoperative and postoperative Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) scores before and after surgeries, recovery rates (RRs), C2-7 lordosis, and fusion success rates were evaluated.
RESULTS: A total of 50 cases (35 males, 15 females) of CLPF were included in this study. Their mean age was 60.5 ± 14.0 years. Average clinical follow-up was 24.6 ± 16.1 months. Mean preoperative and postoperative NDI scores were 27.0 ± 10.6 and 17.6 ± 7.2, respectively (p = 0.004). Mean preoperative and postoperative JOA scores was 10.4 ± 4.2 and 13.6 ± 3.0, respectively (p = 0.001). JOA RR (%) was 49.8 ± 42.2. No significant changes in C2-7 lordosis were noted after surgery (preoperative: 7.0 ± 8.0º; postoperative: 7.3 ± 6.3º; p = 0.789). Fusion success rate was 96% (48/50). Fusion mass areas at C5 level were significantly different between the opening side and the hinge side (opening side = 15.8 ± 13.1 mm2, hinge side = 50.8 ± 27.2 mm2, p < 0.001). There was no postoperative restenosis or epidural fibrosis.
CONCLUSION: CLPF might be useful for canal decompression and good fusion bed while avoiding postoperative epidural fibrosis.
PMID: 29325950 [PubMed - as supplied by publisher]
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