TY - JOUR
T1 - Radiographic and clinical results of C1 laminoplasty for the treatment of compressive myelopathy
AU - Tarukado, Kiyoshi
AU - Ikuta, Ko
AU - Iida, Keiichiro
AU - Tono, Osamu
AU - Doi, Toshio
AU - Harimaya, Katsumi
N1 - Publisher Copyright:
© 2020 by Korean Society of Spine Surgery.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Study Design: Case series. Purpose: To evaluate the radiographic and clinical results of C1 laminoplasty without fusion. Overview of Literature: C1 laminectomy has been the standard procedure for decompression at the C1 level. However, there have been some reports of trouble cases after C1 laminectomy. C1 laminoplasty might be superior to C1 laminectomy with regard to maintaining the original C1 anatomical shape, preventing compression from the posterior soft tissue, and ensuring an adequate bonegrafting site around the C1 posterior part if additional salvage fusion surgery is necessary afterward. Methods: Seven patients with spinal cord compression without obvious segmental instability at the C1/2 level treated by C1 laminoplasty were included. The indication of C1 laminoplasty was same as that of C1 laminectomy. C1 laminoplasty was performed in the same way as subaxial double-door laminoplasty. The imaging findings were evaluated using X-ray, computed tomography, and magnetic resonance imaging. The clinical results were evaluated using the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and JOA score. Peri- and postoperative complications were also investigated. Results: No patient showed increased C1/2 segmental instability after the surgery. The mean pre- and postoperative JOA scores were 8.6 and 11.7, respectively. The mean recovery rate was 40.2%. The effective rate in the JOACMEQ was 50% for the cervical spine function, 33% for the upper extremity function, 50% for the lower extremity function, 17% for the bladder function, and 17% for the quality of life. No major complication that seemed to be unique to C1 laminoplasty was observed over a period of about 4 years follow-up. Conclusions: C1 laminoplasty for patients without obvious segmental instability might be a viable alternative procedure to C1 laminectomy.
AB - Study Design: Case series. Purpose: To evaluate the radiographic and clinical results of C1 laminoplasty without fusion. Overview of Literature: C1 laminectomy has been the standard procedure for decompression at the C1 level. However, there have been some reports of trouble cases after C1 laminectomy. C1 laminoplasty might be superior to C1 laminectomy with regard to maintaining the original C1 anatomical shape, preventing compression from the posterior soft tissue, and ensuring an adequate bonegrafting site around the C1 posterior part if additional salvage fusion surgery is necessary afterward. Methods: Seven patients with spinal cord compression without obvious segmental instability at the C1/2 level treated by C1 laminoplasty were included. The indication of C1 laminoplasty was same as that of C1 laminectomy. C1 laminoplasty was performed in the same way as subaxial double-door laminoplasty. The imaging findings were evaluated using X-ray, computed tomography, and magnetic resonance imaging. The clinical results were evaluated using the Japanese Orthopaedic Association (JOA) Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) and JOA score. Peri- and postoperative complications were also investigated. Results: No patient showed increased C1/2 segmental instability after the surgery. The mean pre- and postoperative JOA scores were 8.6 and 11.7, respectively. The mean recovery rate was 40.2%. The effective rate in the JOACMEQ was 50% for the cervical spine function, 33% for the upper extremity function, 50% for the lower extremity function, 17% for the bladder function, and 17% for the quality of life. No major complication that seemed to be unique to C1 laminoplasty was observed over a period of about 4 years follow-up. Conclusions: C1 laminoplasty for patients without obvious segmental instability might be a viable alternative procedure to C1 laminectomy.
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U2 - 10.31616/asj.2020.0190
DO - 10.31616/asj.2020.0190
M3 - Article
AN - SCOPUS:85090920473
VL - 14
SP - 459
EP - 465
JO - Asian Spine Journal
JF - Asian Spine Journal
SN - 1976-1902
IS - 4
ER -