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Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study.
Spine (Phila Pa 1976). 2007 Aug 15; 32(18):1980-5.S

Abstract

STUDY DESIGN

A prospective randomized clinical trial in surgical treatment for cervical compressive myelopathy.

OBJECTIVE

We prospectively compared modified laminoplasty and skip laminectomy in terms of surgical invasiveness, postoperative range of cervical motion, axial pain, and surgical outcomes.

SUMMARY OF BACKGROUND DATA

Laminoplasty is an established procedure for the decompression of multisegmental cervical compressive myelopathy. However, it often induces postoperative problems, such as axial pain, restriction of neck motion, and loss of lordotic alignment. Skip laminectomy was recently developed as a minimally invasive procedure.

METHODS

Forty-one patients with cervical spondylotic myelopathy (CSM), excluding developmental stenosis, were randomized to modified double-door laminoplasty (Lamino group; n = 21) or skip laminectomy (Skip group; n = 20), and followed for more than 1 year (average, 28.1 months). Of these patients, radiographs were taken in neutral, extension, and flexion positions before surgery and after surgery. The cervical alignment of C2-C7 curvature and range of motion (ROM) were calculated. After surgery patients were asked to rate their neck pain, using the visual analogue scale (VAS) periodically. Clinical outcomes were estimated with the Japanese Orthopedic Association scoring system (JOA score).

RESULTS

There was no significant difference about operative time and blood loss between Lamino and Skip groups. The C2-C7 lordosis of neutral position in both groups was decreased by a few degrees at final follow-up. The final ROMs were 77.4/88.6% of preoperative ROM, respectively. At all collection times, no significant difference in VAS score of axial pain was seen in either group. There was no significant difference in JOA score between both groups before and after surgery.

CONCLUSION

No significant differences were seen between Lamino and Skip groups, in terms of operative invasiveness, axial neck pain, cervical alignment, and ROM, and clinical results in the patients of CSM without developmental stenosis.

Authors+Show Affiliations

Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan. yukawa.ort@chubuh.rofuku.go.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17700444

Citation

Yukawa, Yasutsugu, et al. "Laminoplasty and Skip Laminectomy for Cervical Compressive Myelopathy: Range of Motion, Postoperative Neck Pain, and Surgical Outcomes in a Randomized Prospective Study." Spine, vol. 32, no. 18, 2007, pp. 1980-5.
Yukawa Y, Kato F, Ito K, et al. Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study. Spine. 2007;32(18):1980-5.
Yukawa, Y., Kato, F., Ito, K., Horie, Y., Hida, T., Ito, Z., & Matsuyama, Y. (2007). Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study. Spine, 32(18), 1980-5.
Yukawa Y, et al. Laminoplasty and Skip Laminectomy for Cervical Compressive Myelopathy: Range of Motion, Postoperative Neck Pain, and Surgical Outcomes in a Randomized Prospective Study. Spine. 2007 Aug 15;32(18):1980-5. PubMed PMID: 17700444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study. AU - Yukawa,Yasutsugu, AU - Kato,Fumihiko, AU - Ito,Keigo, AU - Horie,Yumiko, AU - Hida,Tetsurou, AU - Ito,Zenya, AU - Matsuyama,Yukihiro, PY - 2007/8/19/pubmed PY - 2007/9/25/medline PY - 2007/8/19/entrez SP - 1980 EP - 5 JF - Spine JO - Spine VL - 32 IS - 18 N2 - STUDY DESIGN: A prospective randomized clinical trial in surgical treatment for cervical compressive myelopathy. OBJECTIVE: We prospectively compared modified laminoplasty and skip laminectomy in terms of surgical invasiveness, postoperative range of cervical motion, axial pain, and surgical outcomes. SUMMARY OF BACKGROUND DATA: Laminoplasty is an established procedure for the decompression of multisegmental cervical compressive myelopathy. However, it often induces postoperative problems, such as axial pain, restriction of neck motion, and loss of lordotic alignment. Skip laminectomy was recently developed as a minimally invasive procedure. METHODS: Forty-one patients with cervical spondylotic myelopathy (CSM), excluding developmental stenosis, were randomized to modified double-door laminoplasty (Lamino group; n = 21) or skip laminectomy (Skip group; n = 20), and followed for more than 1 year (average, 28.1 months). Of these patients, radiographs were taken in neutral, extension, and flexion positions before surgery and after surgery. The cervical alignment of C2-C7 curvature and range of motion (ROM) were calculated. After surgery patients were asked to rate their neck pain, using the visual analogue scale (VAS) periodically. Clinical outcomes were estimated with the Japanese Orthopedic Association scoring system (JOA score). RESULTS: There was no significant difference about operative time and blood loss between Lamino and Skip groups. The C2-C7 lordosis of neutral position in both groups was decreased by a few degrees at final follow-up. The final ROMs were 77.4/88.6% of preoperative ROM, respectively. At all collection times, no significant difference in VAS score of axial pain was seen in either group. There was no significant difference in JOA score between both groups before and after surgery. CONCLUSION: No significant differences were seen between Lamino and Skip groups, in terms of operative invasiveness, axial neck pain, cervical alignment, and ROM, and clinical results in the patients of CSM without developmental stenosis. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/17700444/Laminoplasty_and_skip_laminectomy_for_cervical_compressive_myelopathy:_range_of_motion_postoperative_neck_pain_and_surgical_outcomes_in_a_randomized_prospective_study_ L2 - http://dx.doi.org/10.1097/BRS.0b013e318133fbce DB - PRIME DP - Unbound Medicine ER -