Erschienen in:
01.03.2011 | Symposium: Current Concepts in Cervical Spine Surgery
Laminoplasty versus Laminectomy and Fusion for Multilevel Cervical Spondylotic Myelopathy
verfasst von:
Barrett I. Woods, MD, Justin Hohl, MD, Joon Lee, MD, William Donaldson III, MD, James Kang, MD
Erschienen in:
Clinical Orthopaedics and Related Research®
|
Ausgabe 3/2011
Einloggen, um Zugang zu erhalten
Abstract
Background
Cervical spondylotic myelopathy is increasingly prevalent in the elderly and is the leading cause of spinal cord dysfunction in this population. Laminectomy with fusion and laminoplasty halt progression of myelopathy in these patients; however, both procedures have well-documented complications and associated morbidity and it is unclear which might be most advantageous.
Questions/purposes
We therefore compared the pain, function and alignment of patients who underwent laminectomy with fusion to those with laminoplasty for the treatment of multilevel cervical spondylotic myelopathy.
Methods
We performed a retrospective matched cohort analysis on all 121 patients from 2002 to 2007 who underwent laminectomy with fusion (82) or laminoplasty (39) for multilevel cervical spondylotic myelopathy. We determined change in preoperative and postoperative sagittal alignment using Cobb measurement, development of junctional stenosis, and subjective improvements in pain and gait. Complications were recorded for both cohorts.
Results
The majority of patients in both cohorts reported improvements in pain and gait postoperatively. There were seven complications in the laminectomy and fusion cohort (9%) with two patients requiring formal revision surgery (2%). There were five complications in the laminoplasty cohort (13%) with two formal revision procedures (5%).
Conclusions
Patients in both the laminectomy with fusion and laminoplasty cohorts reported similar functional improvements after treatment for cervical spondylotic myelopathy. Prospective randomized control trials are needed to determine whether one procedure is truly superior.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.