Tags

Type your tag names separated by a space and hit enter

Volumetric analysis of bilateral spinal canal decompression via hemilaminectomy versus laminoplasty in cervical spondylotic myelopathy.
Acta Neurochir (Wien). 2020 Jun 25 [Online ahead of print]AN

Abstract

BACKGROUND

Cervical spondylotic myelopathy (CSM) is a degenerative process of the cervical spine requiring surgical decompression to prevent neurological deterioration. While both anterior and posterior approaches yield satisfactory results, posterior decompression is preferred in cases of the multilevel disease. In 2015, we described a muscle-sparing, novel technique of bilateral osteoligamentous decompression via hemilaminectomy (OLD) for CSM. In this study, we investigate whether this technique offers comparable volumetric results to laminoplasty in terms of spinal canal enlargement and whether this technique can yield significant clinical improvement.

METHODS

Patients undergoing OLD due to CSM were prospectively enrolled in this study and then matched to and compared with a historic cohort of patients with CSM treated by laminoplasty. An independent sample t test was performed to analyze whether the volumetric gain in the two separate groups was statistically significant. Patients in the OLD cohort were clinically evaluated with the mJOA score preoperatively and 3 months postoperatively. To assess clinical improvement, a paired sample t test was performed.

RESULTS

A total of 38 patients were included in the analysis: 19 underwent OLD and 19 underwent laminoplasty. Both groups were well matched in terms of sex, age, preoperative spinal canal volume, and involved levels. Both surgical methods yielded statistically significant volumetric gain in the cervical spinal canal, but a trend towards a greater volume gain was seen in the OLD group. In the OLD group, a statistically significant clinical improvement was also demonstrated.

CONCLUSIONS

Our study reveals that OLD can yield a comparable extent of decompression to laminoplasty in CSM while also delivering statistically significant clinical improvement.

Authors+Show Affiliations

Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany. silvia.hernandez@med.uni-goettingen.de.Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany. Department of Neurological Surgery, Stadt Krankenhaus Korbach gGmbH, Dr.-Hartwig-Str. 19, 34497, Korbach, Germany.Department of Neuroradiology, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany. Department of Neurological Surgery, Klinikum Vest GmbH, Dorstener Str. 151, 45657, Recklinghausen, Germany.Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.Department of Neurological Surgery, Universitaetsmedizin Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32583084

Citation

Hernández-Durán, Silvia, et al. "Volumetric Analysis of Bilateral Spinal Canal Decompression Via Hemilaminectomy Versus Laminoplasty in Cervical Spondylotic Myelopathy." Acta Neurochirurgica, 2020.
Hernández-Durán S, Zafar N, Behme D, et al. Volumetric analysis of bilateral spinal canal decompression via hemilaminectomy versus laminoplasty in cervical spondylotic myelopathy. Acta Neurochir (Wien). 2020.
Hernández-Durán, S., Zafar, N., Behme, D., Momber, M., Rohde, V., Mielke, D., & Fiss, I. (2020). Volumetric analysis of bilateral spinal canal decompression via hemilaminectomy versus laminoplasty in cervical spondylotic myelopathy. Acta Neurochirurgica. https://doi.org/10.1007/s00701-020-04453-z
Hernández-Durán S, et al. Volumetric Analysis of Bilateral Spinal Canal Decompression Via Hemilaminectomy Versus Laminoplasty in Cervical Spondylotic Myelopathy. Acta Neurochir (Wien). 2020 Jun 25; PubMed PMID: 32583084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Volumetric analysis of bilateral spinal canal decompression via hemilaminectomy versus laminoplasty in cervical spondylotic myelopathy. AU - Hernández-Durán,Silvia, AU - Zafar,Noman, AU - Behme,Daniel, AU - Momber,Matthias, AU - Rohde,Veit, AU - Mielke,Dorothee, AU - Fiss,Ingo, Y1 - 2020/06/25/ PY - 2020/04/28/received PY - 2020/06/08/accepted PY - 2020/6/26/entrez KW - Cervical spondylotic myelopathy KW - Laminoplasty KW - Laminotomy KW - Volume gain JF - Acta neurochirurgica JO - Acta Neurochir (Wien) N2 - BACKGROUND: Cervical spondylotic myelopathy (CSM) is a degenerative process of the cervical spine requiring surgical decompression to prevent neurological deterioration. While both anterior and posterior approaches yield satisfactory results, posterior decompression is preferred in cases of the multilevel disease. In 2015, we described a muscle-sparing, novel technique of bilateral osteoligamentous decompression via hemilaminectomy (OLD) for CSM. In this study, we investigate whether this technique offers comparable volumetric results to laminoplasty in terms of spinal canal enlargement and whether this technique can yield significant clinical improvement. METHODS: Patients undergoing OLD due to CSM were prospectively enrolled in this study and then matched to and compared with a historic cohort of patients with CSM treated by laminoplasty. An independent sample t test was performed to analyze whether the volumetric gain in the two separate groups was statistically significant. Patients in the OLD cohort were clinically evaluated with the mJOA score preoperatively and 3 months postoperatively. To assess clinical improvement, a paired sample t test was performed. RESULTS: A total of 38 patients were included in the analysis: 19 underwent OLD and 19 underwent laminoplasty. Both groups were well matched in terms of sex, age, preoperative spinal canal volume, and involved levels. Both surgical methods yielded statistically significant volumetric gain in the cervical spinal canal, but a trend towards a greater volume gain was seen in the OLD group. In the OLD group, a statistically significant clinical improvement was also demonstrated. CONCLUSIONS: Our study reveals that OLD can yield a comparable extent of decompression to laminoplasty in CSM while also delivering statistically significant clinical improvement. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/32583084/Volumetric_analysis_of_bilateral_spinal_canal_decompression_via_hemilaminectomy_versus_laminoplasty_in_cervical_spondylotic_myelopathy L2 - https://dx.doi.org/10.1007/s00701-020-04453-z DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.