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European Journal of Orthopaedic Surgery & Traumatology

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01-07-2019 | Laminectomy | Original Article • SPINE - CERVICAL

Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy

Authors: G. Gargiulo, M. Girardo, A. Rava, A. Coniglio, P. Cinnella, A. Massè, F. Fusini

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2019

Abstract

Background

Posterior stabilization in patients treated with laminectomy for spondylotic cervical myelopathy is still a debate. Despite both being reported in literature by several authors, some controversies still exist. The aim of this study is to compare clinical and radiological outcomes in patients treated with laminectomy or laminectomy with posterior stabilization.

Material and methods

We retrospectively evaluated 42 patients affected by cervical myelopathy (mean age 70.43 ± 5.03 years), 19 treated with laminectomy (group A) and 23 with laminectomy and posterior instrumentation (group B). Neurological status was assessed with Nurick scale, pain with VAS and radiological parameters with C2–C7 SVA, T1 slope and C2–C7 lordosis, clinical function with modified Japanese Orthopaedic Association score (JOA). Also, surgery time and blood loss were recorded. Student’s t test was used for continuous variables, while Kruskal–Wallis test was used for categorical values.

Results

No differences were found in postoperative Nurick scale (p = 0.587), VAS (p = 0.62), mJOA (p = 0.197) and T1 slope (p = 0.559), while laminectomy with fusion showed better postoperative cervical lordosis (p = 0.007) and C2–C7 SVA (p < 0.00001), but higher blood loss (p < 0.00001) and surgical time (p < 0.00001). Both groups showed better Nurick scale (p = 0.00017 for group A and p = 0.00081 for group B), VAS (p = 0.02 for group A and p = 0.046 for group B) and mJOA (p < 0.00001 for both groups) than preoperative values.

Conclusions

Both treatments are a valuable choice, offering some benefits and disadvantages against each other. Each procedure must be carefully evaluated on the basis of patients’ general status, preoperative pain, signs of instability and potential benefits from cervical alignment correction.

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Title: Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy
Authors: G. Gargiulo
M. Girardo
A. Rava
A. Coniglio
P. Cinnella
A. Massè
F. Fusini
Publication date: 01-07-2019
Publisher: Springer Paris
Keywords: Laminectomy
Cervical Myelopathy
Neck Pain
Chronic Obstructive Lung Disease
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02395-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy

Abstract

Background

Material and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Material and methods

Results

Conclusions

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