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Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report.
J Spinal Disord Tech. 2009 Dec; 22(8):586-92.JS

Abstract

STUDY DESIGN

A preliminary report of a new operative method termed selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials (SCEPs) in elderly patients with cervical spondylotic myelopathy.

OBJECTIVE

To introduce the method and clinical results for selective laminoplasty.

SUMMARY OF BACKGROUND DATA

Clinical results for conventional laminoplasty and anterior decompression and fusion guided by SCEPs have been reported. However, there have been no reports that consider SCEP results for selecting the optimal level in lamioplasty for cervical spondylotic myelopathy.

METHODS

Seven elderly patients who underwent selective laminoplasty were followed for a minimum of 12 months. The T2-high-intensity area on magnetic resonance imaging, the responsible level detected by SCEPs, and the laminoplasty level were recorded. The operative time, intraoperative bleeding, clinical results including the Japanese Orthopaedic Association score, recovery rate, Nurick grading scale, and visual analog scale of axial pain were investigated preoperatively and postoperatively.

RESULTS

The responsible intervertebral levels were at C3-C4 in 3 patients and at C4-C5 in 4 patients. These were identical for SCEP recorded after median nerve stimulation and transcranial electric stimulation. High-intensity area on T2-weighted magnetic resonance imaging was seen in 6 patients (3 at C3-C4 and 3 at C4-C5). The average operative time was 106 minutes and the average amount of bleeding was 20 mL. Neurologic recovery was achieved in all patients except 1 who had severe myelopathy. Visual analog scales of axial pain were 41.3 + or - 33.9 before surgery and 18.0 + or - 19.4 at final follow-up. The Japanese Orthopaedic Association score and the Nurick grade improved in 6 patients but did not change in 1 patient.

CONCLUSIONS

Preliminary clinical results for selective laminoplasty were satisfactory in all but 1 case. Although long-term results are not yet available, we consider this method to be less invasive and capable of giving satisfactory clinical results and benefits for elderly patients.

Authors+Show Affiliations

Department of Orthopedic Surgery Yamaguchi University Graduate School of Medicine, 1-1-1, Minami-Kogushi, Ube, Yamaguchi, Japan. kato-yo@yamaguchi-uac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

19956033

Citation

Kato, Yoshihiko, et al. "Selective Laminoplasty After the Preoperative Diagnosis of the Responsible Level Using Spinal Cord Evoked Potentials in Elderly Patients With Cervical Spondylotic Myelopathy: a Preliminary Report." Journal of Spinal Disorders & Techniques, vol. 22, no. 8, 2009, pp. 586-92.
Kato Y, Kojima T, Kataoka H, et al. Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report. J Spinal Disord Tech. 2009;22(8):586-92.
Kato, Y., Kojima, T., Kataoka, H., Imajo, Y., Yara, T., Yoshida, Y., Imagama, T., & Taguchi, T. (2009). Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report. Journal of Spinal Disorders & Techniques, 22(8), 586-92. https://doi.org/10.1097/BSD.0b013e3181929ca2
Kato Y, et al. Selective Laminoplasty After the Preoperative Diagnosis of the Responsible Level Using Spinal Cord Evoked Potentials in Elderly Patients With Cervical Spondylotic Myelopathy: a Preliminary Report. J Spinal Disord Tech. 2009;22(8):586-92. PubMed PMID: 19956033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report. AU - Kato,Yoshihiko, AU - Kojima,Takanori, AU - Kataoka,Hideo, AU - Imajo,Yasuaki, AU - Yara,Takahiro, AU - Yoshida,Yuichiro, AU - Imagama,Takashi, AU - Taguchi,Toshihiko, PY - 2009/12/4/entrez PY - 2009/12/4/pubmed PY - 2010/3/6/medline SP - 586 EP - 92 JF - Journal of spinal disorders & techniques JO - J Spinal Disord Tech VL - 22 IS - 8 N2 - STUDY DESIGN: A preliminary report of a new operative method termed selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials (SCEPs) in elderly patients with cervical spondylotic myelopathy. OBJECTIVE: To introduce the method and clinical results for selective laminoplasty. SUMMARY OF BACKGROUND DATA: Clinical results for conventional laminoplasty and anterior decompression and fusion guided by SCEPs have been reported. However, there have been no reports that consider SCEP results for selecting the optimal level in lamioplasty for cervical spondylotic myelopathy. METHODS: Seven elderly patients who underwent selective laminoplasty were followed for a minimum of 12 months. The T2-high-intensity area on magnetic resonance imaging, the responsible level detected by SCEPs, and the laminoplasty level were recorded. The operative time, intraoperative bleeding, clinical results including the Japanese Orthopaedic Association score, recovery rate, Nurick grading scale, and visual analog scale of axial pain were investigated preoperatively and postoperatively. RESULTS: The responsible intervertebral levels were at C3-C4 in 3 patients and at C4-C5 in 4 patients. These were identical for SCEP recorded after median nerve stimulation and transcranial electric stimulation. High-intensity area on T2-weighted magnetic resonance imaging was seen in 6 patients (3 at C3-C4 and 3 at C4-C5). The average operative time was 106 minutes and the average amount of bleeding was 20 mL. Neurologic recovery was achieved in all patients except 1 who had severe myelopathy. Visual analog scales of axial pain were 41.3 + or - 33.9 before surgery and 18.0 + or - 19.4 at final follow-up. The Japanese Orthopaedic Association score and the Nurick grade improved in 6 patients but did not change in 1 patient. CONCLUSIONS: Preliminary clinical results for selective laminoplasty were satisfactory in all but 1 case. Although long-term results are not yet available, we consider this method to be less invasive and capable of giving satisfactory clinical results and benefits for elderly patients. SN - 1539-2465 UR - https://www.unboundmedicine.com/medline/citation/19956033/Selective_laminoplasty_after_the_preoperative_diagnosis_of_the_responsible_level_using_spinal_cord_evoked_potentials_in_elderly_patients_with_cervical_spondylotic_myelopathy:_a_preliminary_report_ L2 - http://dx.doi.org/10.1097/BSD.0b013e3181929ca2 DB - PRIME DP - Unbound Medicine ER -