Il Sup Kim1, Jae Taek Hong2, Jung Jae Lee1, Jong Bum Lee1, Chul Bum Cho1, Seung Ho Yang1, Jae Hoon Sung1. 1. Department of Neurosurgery, Catholic University of Korea, St. Vincent's Hospital, Suwon, Gyeonggi-do, South Korea. 2. Department of Neurosurgery, Catholic University of Korea, St. Vincent's Hospital, Suwon, Gyeonggi-do, South Korea. Electronic address: jatagi@daum.net.
Abstract
BACKGROUND: Cervical laminectomy has 2 major disadvantages: postlaminectomy adhesion of dural membrane and lack of a fusion bed. The objective of this study was to determine whether simultaneous cervical laminoplasty with fusion (CLPF) might overcome these unwanted outcomes. METHODS: Patients who underwent CLPF for treating cervical myelopathy with instability who were followed up for at least 12 months were enrolled. Preoperative and postoperative Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores before and after surgery, recovery rates (RRs), C2-C7 lordosis, and fusion success rates were evaluated. RESULTS: The study cohort comprised 50 patients (35 males and 15 females; mean age, 60.5 ± 14.0 years) who underwent CLPF. The average duration of 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 were 10.4 ± 4.2 and 13.6 ± 3.0, respectively (P = 0.001). The mean JOA RR was 49.8 ± 42.2%. No significant changes in C2-7 lordosis were noted after surgery (preoperative, 7.0 ± 8.0°; postoperative, 7.3 ± 6.3°; P = 0.789). The fusion success rate was 96% (48 of 50 patients). 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. CONCLUSIONS: CLPF might be useful for canal decompression and a good fusion bed while avoiding postoperative epidural fibrosis.
BACKGROUND: Cervical laminectomy has 2 major disadvantages: postlaminectomy adhesion of dural membrane and lack of a fusion bed. The objective of this study was to determine whether simultaneous cervical laminoplasty with fusion (CLPF) might overcome these unwanted outcomes. METHODS:Patients who underwent CLPF for treating cervical myelopathy with instability who were followed up for at least 12 months were enrolled. Preoperative and postoperative Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) scores before and after surgery, recovery rates (RRs), C2-C7 lordosis, and fusion success rates were evaluated. RESULTS: The study cohort comprised 50 patients (35 males and 15 females; mean age, 60.5 ± 14.0 years) who underwent CLPF. The average duration of 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 were 10.4 ± 4.2 and 13.6 ± 3.0, respectively (P = 0.001). The mean JOA RR was 49.8 ± 42.2%. No significant changes in C2-7 lordosis were noted after surgery (preoperative, 7.0 ± 8.0°; postoperative, 7.3 ± 6.3°; P = 0.789). The fusion success rate was 96% (48 of 50 patients). 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. CONCLUSIONS: CLPF might be useful for canal decompression and a good fusion bed while avoiding postoperative epidural fibrosis.