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Operative treatment of cervical myelopathy: cervical laminoplasty.

Braly BA, Lunardini D, Cornett C, Donaldson WF - Adv Orthop (2012)

Bottom Line: Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention.Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits.Current literature supports the use of laminoplasty for indicated decompression.

View Article: PubMed Central - PubMed

Affiliation: Univeristy of Pittsburgh Medical Center, Pittsburgh, PA, USA.

ABSTRACT
Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or "hinged", laminoplasty.

No MeSH data available.


Related in: MedlinePlus

Lateral radiograph of the cervical spine in a patient who underwent laminoplasty. Note that there is an overall lordotic alignment which will allow for posterior drift once a posterior decompression is performed.
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fig1: Lateral radiograph of the cervical spine in a patient who underwent laminoplasty. Note that there is an overall lordotic alignment which will allow for posterior drift once a posterior decompression is performed.

Mentions: Several factors must be considered in selecting the appropriate patient for laminoplasty. As mentioned, cervical laminoplasty is indicated for multilevel stenosis (AP canal diameter < 13 mm) due to spondylosis or OPLL (Figures 1, 2, and 3). The procedure is generally contraindicated in kyphotic cervical pathology as there is less room for posterior drift of the cord; however, up to 10 degrees of cervical kyphosis has been shown to have acceptable results [11, 12, 14]. Further contraindications include previous posterior cervical surgery, ossification of the ligamentum flavum (OLF), and epidural fibrosis. Preservation of the posterior elements allows for reinsertion of the nuchal muscles and spinal ligaments, allowing for better preservation of lordosis. Single- or two-level stenosis may best be treated from an anterior approach.


Operative treatment of cervical myelopathy: cervical laminoplasty.

Braly BA, Lunardini D, Cornett C, Donaldson WF - Adv Orthop (2012)

Lateral radiograph of the cervical spine in a patient who underwent laminoplasty. Note that there is an overall lordotic alignment which will allow for posterior drift once a posterior decompression is performed.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3368162&req=5

fig1: Lateral radiograph of the cervical spine in a patient who underwent laminoplasty. Note that there is an overall lordotic alignment which will allow for posterior drift once a posterior decompression is performed.
Mentions: Several factors must be considered in selecting the appropriate patient for laminoplasty. As mentioned, cervical laminoplasty is indicated for multilevel stenosis (AP canal diameter < 13 mm) due to spondylosis or OPLL (Figures 1, 2, and 3). The procedure is generally contraindicated in kyphotic cervical pathology as there is less room for posterior drift of the cord; however, up to 10 degrees of cervical kyphosis has been shown to have acceptable results [11, 12, 14]. Further contraindications include previous posterior cervical surgery, ossification of the ligamentum flavum (OLF), and epidural fibrosis. Preservation of the posterior elements allows for reinsertion of the nuchal muscles and spinal ligaments, allowing for better preservation of lordosis. Single- or two-level stenosis may best be treated from an anterior approach.

Bottom Line: Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention.Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits.Current literature supports the use of laminoplasty for indicated decompression.

View Article: PubMed Central - PubMed

Affiliation: Univeristy of Pittsburgh Medical Center, Pittsburgh, PA, USA.

ABSTRACT
Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or "hinged", laminoplasty.

No MeSH data available.


Related in: MedlinePlus