Tags

Type your tag names separated by a space and hit enter

T-Saw laminoplasty for the management of cervical spondylotic myelopathy: clinical and radiographic outcome.
Spine (Phila Pa 1976). 2000 Jul 15; 25(14):1788-94.S

Abstract

STUDY DESIGN

Independent evaluation of 18 patients with multilevel cervical spondylotic myelopathy who underwent threadwire T-saw laminoplasty.

OBJECTIVES

Assess the efficacy of midline T-saw laminoplasty in non-Japanese patients based on clinical and radiographic criteria.

SUMMARY OF BACKGROUND DATA

Spinous process-splitting laminoplasty has been well accepted in Japan. The results in non-Japanese patients are unknown.

METHODS

A single physician performed independent clinical and radiographic evaluations at latest follow-up (mean, 24 months). In addition to a patient self-assessment questionnaire, objective measures included physical examination, Pavlov's ratio, sagittal canal diameter (by computed tomography), cord compression index, cervical lordosis, range of motion, and complications.

RESULTS

Progression of myelopathy was arrested in all patients. Patients reported improvement in strength (78%), dexterity (67%), numbness (83%), pain (83%), and gait (67%). Bowel and bladder compromise resolved in five of six patients. The mean Nurick score improved from 2.7 to 0.9 (P < 0.001), and the mean Robinson pain score improved from 2.0 to 0.89 (P = 0.002). No patient required narcotic analgesics at latest follow-up compared with eight before laminoplasty. Objectively, 68% of patients with motor weakness regained normal strength (P = 0.001), whereas 50% regained normal sensation (P = 0.003). Radiographic canal expansion was verified by a statistically significant increase in the mean Pavlov ratio and osseous sagittal computed tomographic measurements. The mean cord compression index improved from 0.49 to 0.61 (P = 0.01). There was no significant change in mean cervical lordosis. Graft dislodgment or segmental instability did not occur. Complications included: infection (n = 1) and persistent postoperative motor root lesion at C5 (n = 1).

CONCLUSIONS

T-saw laminoplasty appears to be a safe and effective method of arresting the progression of myelopathy and allowing marked functional improvement in most patients with multilevel cervical spondylotic myelopathy. [Key Words: cervical spine, decompression, laminoplasty, myelopathy, spondylosis]

Authors+Show Affiliations

Department of Orthopedic Surgery, Emory University, School of Medicine, Atlanta, Georgia, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10888947

Citation

Edwards, C C., et al. "T-Saw Laminoplasty for the Management of Cervical Spondylotic Myelopathy: Clinical and Radiographic Outcome." Spine, vol. 25, no. 14, 2000, pp. 1788-94.
Edwards CC, Heller JG, Silcox DH. T-Saw laminoplasty for the management of cervical spondylotic myelopathy: clinical and radiographic outcome. Spine. 2000;25(14):1788-94.
Edwards, C. C., Heller, J. G., & Silcox, D. H. (2000). T-Saw laminoplasty for the management of cervical spondylotic myelopathy: clinical and radiographic outcome. Spine, 25(14), 1788-94.
Edwards CC, Heller JG, Silcox DH. T-Saw Laminoplasty for the Management of Cervical Spondylotic Myelopathy: Clinical and Radiographic Outcome. Spine. 2000 Jul 15;25(14):1788-94. PubMed PMID: 10888947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - T-Saw laminoplasty for the management of cervical spondylotic myelopathy: clinical and radiographic outcome. AU - Edwards,C C,2nd AU - Heller,J G, AU - Silcox,D H,3rd PY - 2000/7/11/pubmed PY - 2000/9/2/medline PY - 2000/7/11/entrez SP - 1788 EP - 94 JF - Spine JO - Spine VL - 25 IS - 14 N2 - STUDY DESIGN: Independent evaluation of 18 patients with multilevel cervical spondylotic myelopathy who underwent threadwire T-saw laminoplasty. OBJECTIVES: Assess the efficacy of midline T-saw laminoplasty in non-Japanese patients based on clinical and radiographic criteria. SUMMARY OF BACKGROUND DATA: Spinous process-splitting laminoplasty has been well accepted in Japan. The results in non-Japanese patients are unknown. METHODS: A single physician performed independent clinical and radiographic evaluations at latest follow-up (mean, 24 months). In addition to a patient self-assessment questionnaire, objective measures included physical examination, Pavlov's ratio, sagittal canal diameter (by computed tomography), cord compression index, cervical lordosis, range of motion, and complications. RESULTS: Progression of myelopathy was arrested in all patients. Patients reported improvement in strength (78%), dexterity (67%), numbness (83%), pain (83%), and gait (67%). Bowel and bladder compromise resolved in five of six patients. The mean Nurick score improved from 2.7 to 0.9 (P < 0.001), and the mean Robinson pain score improved from 2.0 to 0.89 (P = 0.002). No patient required narcotic analgesics at latest follow-up compared with eight before laminoplasty. Objectively, 68% of patients with motor weakness regained normal strength (P = 0.001), whereas 50% regained normal sensation (P = 0.003). Radiographic canal expansion was verified by a statistically significant increase in the mean Pavlov ratio and osseous sagittal computed tomographic measurements. The mean cord compression index improved from 0.49 to 0.61 (P = 0.01). There was no significant change in mean cervical lordosis. Graft dislodgment or segmental instability did not occur. Complications included: infection (n = 1) and persistent postoperative motor root lesion at C5 (n = 1). CONCLUSIONS: T-saw laminoplasty appears to be a safe and effective method of arresting the progression of myelopathy and allowing marked functional improvement in most patients with multilevel cervical spondylotic myelopathy. [Key Words: cervical spine, decompression, laminoplasty, myelopathy, spondylosis] SN - 0362-2436 UR - https://www.unboundmedicine.com/medline/citation/10888947/T_Saw_laminoplasty_for_the_management_of_cervical_spondylotic_myelopathy:_clinical_and_radiographic_outcome_ L2 - http://dx.doi.org/10.1097/00007632-200007150-00009 DB - PRIME DP - Unbound Medicine ER -