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Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis.
J Orthop Surg Res. 2015 Sep 04; 10:138.JO

Abstract

BACKGROUND

Posterior laminectomy with instrumented fusion is a standard procedure for treating degenerative cervical kyphosis with stenosis (DCKS). Two major disadvantages of the surgery are adhesion of the dural membrane with significant disfiguring of cervical spine and a small fusion bed around the lateral mass. One of the advantages of laminoplasty over laminectomy is the protection of the dural membrane from adhesion through preservation of posterior bony elements. This study presents the surgical outcomes of laminoplasty, instead of laminectomy, as a decompression method applied in posterior instrumented fusion for DCKS.

METHODS

A consecutive single center series of twenty cases between 2008 and 2011 were retrospectively reviewed. They were diagnosed as DCKS and received anterior cervical fusion followed by expansive open door laminoplasty and lateral mass or pedicle screw instrumented fusion. We collected the functional scores and changes of cervical curvature on the basis of dynamic lateral films preoperatively and postoperatively. We used computed tomography scans and magnetic resonance imaging (MRI) to evaluate the status of fusion and decompression.

RESULTS

The mean age at the time of surgery was 67.6 ± 15.2 years. Half of the patients were older than 75 years. All functional scores and cervical lordotic curvatures markedly improved. No recurrence of spinal cord compression was caused by closure of opened laminae, according to MRI study that was conducted 12 months postoperatively. No pseudarthrosis or hardware loosening was observed 24 months postoperatively.

CONCLUSION

The surgical aims for DCKS are adequate decompression, correction of kyphosis, and solid instrumented fusion. Laminoplasty applied in cervical fusion as a decompression method seems to lead to a favorable functional recovery and reduces the complications of perineural adhesion that typically occur after laminectomy. In addition, laminoplasty affords an additional fusion bed at the hinge side and this advantage benefits solid fusion mass formation for the patients who suffered from DCKS.

Authors+Show Affiliations

Institute of Medical Sciences, Tzu Chi University, No. 701, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. micrograft@gmail.com. Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. micrograft@gmail.com.Institute of Medical Sciences, Tzu Chi University, No. 701, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. fish@mail.tcu.edu.tw.Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. ihchen@tzuchi.com.tw. School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan. ihchen@tzuchi.com.tw.Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. FEYU@tzuchi.com.tw. School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan. FEYU@tzuchi.com.tw.Institute of Medical Sciences, Tzu Chi University, No. 701, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. 102353105@stmail.tcu.edu.tw. Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. 102353105@stmail.tcu.edu.tw.Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. 100353105@stmail.tcu.edu.tw.Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. paulwang@tzuchi.com.tw.Institute of Medical Sciences, Tzu Chi University, No. 701, Zhongyang Rd., Sec. 3, Hualien, 97004, Taiwan. wentien2003@yahoo.com.tw. Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97002, Taiwan. wentien2003@yahoo.com.tw. School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan. wentien2003@yahoo.com.tw.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26338009

Citation

Yeh, Kuang-Ting, et al. "Laminoplasty Instead of Laminectomy as a Decompression Method in Posterior Instrumented Fusion for Degenerative Cervical Kyphosis With Stenosis." Journal of Orthopaedic Surgery and Research, vol. 10, 2015, p. 138.
Yeh KT, Lee RP, Chen IH, et al. Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis. J Orthop Surg Res. 2015;10:138.
Yeh, K. T., Lee, R. P., Chen, I. H., Yu, T. C., Liu, K. L., Peng, C. H., Wang, J. H., & Wu, W. T. (2015). Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis. Journal of Orthopaedic Surgery and Research, 10, 138. https://doi.org/10.1186/s13018-015-0280-y
Yeh KT, et al. Laminoplasty Instead of Laminectomy as a Decompression Method in Posterior Instrumented Fusion for Degenerative Cervical Kyphosis With Stenosis. J Orthop Surg Res. 2015 Sep 4;10:138. PubMed PMID: 26338009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis. AU - Yeh,Kuang-Ting, AU - Lee,Ru-Ping, AU - Chen,Ing-Ho, AU - Yu,Tzai-Chiu, AU - Liu,Kuan-Lin, AU - Peng,Cheng-Huan, AU - Wang,Jen-Hung, AU - Wu,Wen-Tien, Y1 - 2015/09/04/ PY - 2015/06/02/received PY - 2015/08/25/accepted PY - 2015/9/5/entrez PY - 2015/9/5/pubmed PY - 2016/6/25/medline SP - 138 EP - 138 JF - Journal of orthopaedic surgery and research JO - J Orthop Surg Res VL - 10 N2 - BACKGROUND: Posterior laminectomy with instrumented fusion is a standard procedure for treating degenerative cervical kyphosis with stenosis (DCKS). Two major disadvantages of the surgery are adhesion of the dural membrane with significant disfiguring of cervical spine and a small fusion bed around the lateral mass. One of the advantages of laminoplasty over laminectomy is the protection of the dural membrane from adhesion through preservation of posterior bony elements. This study presents the surgical outcomes of laminoplasty, instead of laminectomy, as a decompression method applied in posterior instrumented fusion for DCKS. METHODS: A consecutive single center series of twenty cases between 2008 and 2011 were retrospectively reviewed. They were diagnosed as DCKS and received anterior cervical fusion followed by expansive open door laminoplasty and lateral mass or pedicle screw instrumented fusion. We collected the functional scores and changes of cervical curvature on the basis of dynamic lateral films preoperatively and postoperatively. We used computed tomography scans and magnetic resonance imaging (MRI) to evaluate the status of fusion and decompression. RESULTS: The mean age at the time of surgery was 67.6 ± 15.2 years. Half of the patients were older than 75 years. All functional scores and cervical lordotic curvatures markedly improved. No recurrence of spinal cord compression was caused by closure of opened laminae, according to MRI study that was conducted 12 months postoperatively. No pseudarthrosis or hardware loosening was observed 24 months postoperatively. CONCLUSION: The surgical aims for DCKS are adequate decompression, correction of kyphosis, and solid instrumented fusion. Laminoplasty applied in cervical fusion as a decompression method seems to lead to a favorable functional recovery and reduces the complications of perineural adhesion that typically occur after laminectomy. In addition, laminoplasty affords an additional fusion bed at the hinge side and this advantage benefits solid fusion mass formation for the patients who suffered from DCKS. SN - 1749-799X UR - https://www.unboundmedicine.com/medline/citation/26338009/Laminoplasty_instead_of_laminectomy_as_a_decompression_method_in_posterior_instrumented_fusion_for_degenerative_cervical_kyphosis_with_stenosis_ L2 - https://josr-online.biomedcentral.com/articles/10.1186/s13018-015-0280-y DB - PRIME DP - Unbound Medicine ER -