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Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study.
PLoS One. 2014; 9(4):e95482.Plos

Abstract

OBJECTIVE

To report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM) associated with hypertrophic ligamentum flavum (HLF).

BACKGROUND

Laminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum.

METHODS

This study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA) score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale.

RESULTS

No hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3 ± 15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05). Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit.

CONCLUSION

Hybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients with HLF.

Authors+Show Affiliations

Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24740151

Citation

Ding, Huairong, et al. "Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy With Hypertrophic Ligamentum Flavum: a Retrospective Study." PloS One, vol. 9, no. 4, 2014, pp. e95482.
Ding H, Xue Y, Tang Y, et al. Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study. PLoS ONE. 2014;9(4):e95482.
Ding, H., Xue, Y., Tang, Y., He, D., Li, Z., Zhao, Y., Zong, Y., Wang, Y., & Wang, P. (2014). Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study. PloS One, 9(4), e95482. https://doi.org/10.1371/journal.pone.0095482
Ding H, et al. Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy With Hypertrophic Ligamentum Flavum: a Retrospective Study. PLoS ONE. 2014;9(4):e95482. PubMed PMID: 24740151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study. AU - Ding,Huairong, AU - Xue,Yuan, AU - Tang,Yanming, AU - He,Dong, AU - Li,Zhiyang, AU - Zhao,Ying, AU - Zong,Yaqi, AU - Wang,Yi, AU - Wang,Pei, Y1 - 2014/04/16/ PY - 2013/12/11/received PY - 2014/03/26/accepted PY - 2014/4/18/entrez PY - 2014/4/18/pubmed PY - 2015/6/2/medline SP - e95482 EP - e95482 JF - PloS one JO - PLoS ONE VL - 9 IS - 4 N2 - OBJECTIVE: To report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM) associated with hypertrophic ligamentum flavum (HLF). BACKGROUND: Laminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum. METHODS: This study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA) score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale. RESULTS: No hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3 ± 15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05). Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit. CONCLUSION: Hybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients with HLF. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24740151/Laminoplasty_and_laminectomy_hybrid_decompression_for_the_treatment_of_cervical_spondylotic_myelopathy_with_hypertrophic_ligamentum_flavum:_a_retrospective_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0095482 DB - PRIME DP - Unbound Medicine ER -