Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy
Objectives: Expansive open-door laminoplasty (EOLP) is effective for multilevel cervical spondylotic myelopathy (MCSM). When MCSM is combined with one- or two-level segmental kyphosis, instability, or major anterior foci, EOLP with short-segment anterior cervical fusion (ACF) results in good short-t...
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| Format: | Article |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Tzu Chi Medical Journal |
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| Online Access: | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=1;spage=47;epage=51;aulast=Wu |
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| author | Tsung-Chiao Wu Kuang-Ting Yeh Ru-Ping Lee Tzai-Chiu Yu Ing-Ho Chen Cheng-Huan Peng Kuan-Lin Liu Jen-Hung Wang Wen-Tien Wu |
| author_facet | Tsung-Chiao Wu Kuang-Ting Yeh Ru-Ping Lee Tzai-Chiu Yu Ing-Ho Chen Cheng-Huan Peng Kuan-Lin Liu Jen-Hung Wang Wen-Tien Wu |
| author_sort | Tsung-Chiao Wu |
| collection | DOAJ |
| description | Objectives: Expansive open-door laminoplasty (EOLP) is effective for multilevel cervical spondylotic myelopathy (MCSM). When MCSM is combined with one- or two-level segmental kyphosis, instability, or major anterior foci, EOLP with short-segment anterior cervical fusion (ACF) results in good short-term neurological recovery and can preserve postoperative range of motion (ROM). The objective of this study was to evaluate the medium-term clinical outcomes of this procedure and to analyze the risk factors affecting the neurological function at the last follow-up. Materials and Methods: A total of 87 patients were enrolled in this retrospective study conducted from January 2007 to May 2011. These patients exhibited MCSM with combined short segmental kyphosis, instability, or major anterior pathology, and received EOLP and short-segment anterior fusion. The follow-up period lasted at least 60 months. The radiographic outcomes were collected from plain radiographs with dynamic views checked preoperatively and at the last follow-up. Neurological status and visual analog scale scores for neck pain were evaluated. Logistic regression analysis was then applied to determine the correlation between radiographic parameters and rates of neurological recovery. Results: The mean Japanese Orthopedics Association recovery rate at the last follow-up was 77.8%. The improvement in functional scores and reduction in neck pain were statistically significant. The most influential risk factor affecting neurologic recovery was preoperative functional status. Conclusions: EOLP followed by short-segment ACF is a favorable treatment for patients with MCSM with concomitant short-segment kyphosis, instability, or major anterior pathology. |
| format | Article |
| id | doaj-art-af3e04a983954d43a0634f6bf869e664 |
| institution | Kabale University |
| issn | 1016-3190 2223-8956 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Tzu Chi Medical Journal |
| spelling | doaj-art-af3e04a983954d43a0634f6bf869e6642025-08-20T03:39:05ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562019-01-01311475110.4103/tcmj.tcmj_22_18Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathyTsung-Chiao WuKuang-Ting YehRu-Ping LeeTzai-Chiu YuIng-Ho ChenCheng-Huan PengKuan-Lin LiuJen-Hung WangWen-Tien WuObjectives: Expansive open-door laminoplasty (EOLP) is effective for multilevel cervical spondylotic myelopathy (MCSM). When MCSM is combined with one- or two-level segmental kyphosis, instability, or major anterior foci, EOLP with short-segment anterior cervical fusion (ACF) results in good short-term neurological recovery and can preserve postoperative range of motion (ROM). The objective of this study was to evaluate the medium-term clinical outcomes of this procedure and to analyze the risk factors affecting the neurological function at the last follow-up. Materials and Methods: A total of 87 patients were enrolled in this retrospective study conducted from January 2007 to May 2011. These patients exhibited MCSM with combined short segmental kyphosis, instability, or major anterior pathology, and received EOLP and short-segment anterior fusion. The follow-up period lasted at least 60 months. The radiographic outcomes were collected from plain radiographs with dynamic views checked preoperatively and at the last follow-up. Neurological status and visual analog scale scores for neck pain were evaluated. Logistic regression analysis was then applied to determine the correlation between radiographic parameters and rates of neurological recovery. Results: The mean Japanese Orthopedics Association recovery rate at the last follow-up was 77.8%. The improvement in functional scores and reduction in neck pain were statistically significant. The most influential risk factor affecting neurologic recovery was preoperative functional status. Conclusions: EOLP followed by short-segment ACF is a favorable treatment for patients with MCSM with concomitant short-segment kyphosis, instability, or major anterior pathology.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=1;spage=47;epage=51;aulast=WuAnterior major pathologyExpansive open door laminoplastyJapanese Orthopedic Association recovery rateSegmental instability or local kyphosisShort level anterior cervical fusion |
| spellingShingle | Tsung-Chiao Wu Kuang-Ting Yeh Ru-Ping Lee Tzai-Chiu Yu Ing-Ho Chen Cheng-Huan Peng Kuan-Lin Liu Jen-Hung Wang Wen-Tien Wu Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy Tzu Chi Medical Journal Anterior major pathology Expansive open door laminoplasty Japanese Orthopedic Association recovery rate Segmental instability or local kyphosis Short level anterior cervical fusion |
| title | Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| title_full | Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| title_fullStr | Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| title_full_unstemmed | Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| title_short | Medium-term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| title_sort | medium term clinical outcomes of laminoplasty with adjunct short anterior fusion in multilevel cervical myelopathy |
| topic | Anterior major pathology Expansive open door laminoplasty Japanese Orthopedic Association recovery rate Segmental instability or local kyphosis Short level anterior cervical fusion |
| url | http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2019;volume=31;issue=1;spage=47;epage=51;aulast=Wu |
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