BACKGROUND:Hirabayashi open-door laminoplasty is the most typical surgical treatment option for cervical compressive myelopathy, however, this conventional approach has many complications. To minimize these complications, many modified approaches have been devised. AIMS: To compare clinical outcomes of two different types of open-door laminoplasties for cervical compressive myelopathy. MATERIALS AND METHODS:Fifty patients (31 men and 19 women) with cervical compressive myelopathy were prospectively allocated to two groups, 25 patients in each group. Patients in Group A underwent Hirabayashi open-door laminoplasty and patients in Group B underwent modified instrumented approach. The following parameters were studied: operation time, blood loss, perioperative complications, Japanese Orthopedic Association (JOA) scores, axial pain, and short-form 36 (SF-36). Cervical lordosis was reviewed as lordotic angle, measured at C2-C7. RESULTS:Mean operation time and blood loss in both the groups were similar. Perioperative complications occurred more frequently in Group A than in Group B. Although there were no significant differences in postoperative JOA scores between the two groups, axial pain was significantly decreased in Group B at final follow-up. The scores of all subscales of SF-36 were higher in Group B than in Group A. CONCLUSION: Both the conventional and instrumented techniques provide similar good results but the instrumented technique provided better axial pain relief and lower incidence of perioperative complications.
RCT Entities:
BACKGROUND: Hirabayashi open-door laminoplasty is the most typical surgical treatment option for cervical compressive myelopathy, however, this conventional approach has many complications. To minimize these complications, many modified approaches have been devised. AIMS: To compare clinical outcomes of two different types of open-door laminoplasties for cervical compressive myelopathy. MATERIALS AND METHODS: Fifty patients (31 men and 19 women) with cervical compressive myelopathy were prospectively allocated to two groups, 25 patients in each group. Patients in Group A underwent Hirabayashi open-door laminoplasty and patients in Group B underwent modified instrumented approach. The following parameters were studied: operation time, blood loss, perioperative complications, Japanese Orthopedic Association (JOA) scores, axial pain, and short-form 36 (SF-36). Cervical lordosis was reviewed as lordotic angle, measured at C2-C7. RESULTS: Mean operation time and blood loss in both the groups were similar. Perioperative complications occurred more frequently in Group A than in Group B. Although there were no significant differences in postoperative JOA scores between the two groups, axial pain was significantly decreased in Group B at final follow-up. The scores of all subscales of SF-36 were higher in Group B than in Group A. CONCLUSION: Both the conventional and instrumented techniques provide similar good results but the instrumented technique provided better axial pain relief and lower incidence of perioperative complications.
Authors: I Gusti Lanang Ngurah Agung Artha Wiguna; Rahadyan Magetsari; Zairin Noor; Suyitno Suyitno; Ricvan Dana Nindrea Journal: Open Access Maced J Med Sci Date: 2019-10-13