Comparison of posterior approach surgical techniques for cervical spondylotic myelopathy: laminectomy with fusion, laminoplasty, and laminoplasty with fusion.
Seung Hyeon Han, Sang Hyun Kim, Sung Hyun Noh, Jong Joo Lee, Yoon Ha, Pyung Goo Cho
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引用次数: 0
Abstract
Background context: Laminectomy with fusion (LF), laminoplasty (LP), and laminoplasty with fusion (LPF) are three techniques for posterior cervical decompression. LF can provide stability, but postoperative dural membrane adhesion and fusion failure can occur. LP can prevent postoperative dural membrane adhesion, but it can lead to kyphotic change. To address the disadvantages and further enhance the strengths of each, the LPF technique can be a good option.
Purpose: This study aimed to confirm whether LPF can overcome the disadvantages of LF and LP.
Study design: Single-center, retrospective cohort study.
Patient sample: Twenty patients for each technique were randomly selected.
Outcome measures: Δ C2-7 sagittal vertical axis (SVA), Δ T1 slope, Δ C2-7 Cobb's angle, Δ spinal canal length, and fusion success rate were measured for radiologic outcomes. Preoperative and postoperative Japanese Orthopedic Association (JOA) scores and recovery rates (RRs) were measured for clinical outcomes.
Methods: Patients who underwent LF, LP, or LPF between 2012 and 2023 were enrolled, and 20 patients for each technique were randomly selected. Δ C2-7 sagittal vertical axis (SVA), Δ T1 slope, Δ C2-7 Cobb's angle, Δ spinal canal length, fusion success rate, complications, operation time, blood loss, JOA scores, visual analog scale (VAS) scores, and RRs were measured.
Results: Δ C2-7 Cobb's angle (LPF, -2.62±5.0; LP, -6.43±4.9; p=.020) and Δ C2-7 SVA (LPF, 6.48±8.3; LP, 13.84±9.9; p=.015) were significantly different between LPF and LP. No significant changes in Δ spinal canal length between LPF and LP were observed (LPF, 2.93±1.3; LP, 3.05±1.5; p=.780). The fusion success rate with LPF was higher than that with LF (LPF, 80.0%; LF, 45.0%; p=.027). The JOA RR was the highest with LPF (LPF, 49.96%±24.7; LF, 31.70%±27.8; LP, 29.31%±30.8, p=.045).
Conclusions: LPF can overcome the disadvantages of LF and LP while retaining their benefits.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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