JOURNAL TOOLS |
Publishing options |
eTOC |
To subscribe |
Submit an article |
Recommend to your librarian |
ARTICLE TOOLS |
Publication history |
Reprints |
Permissions |
Cite this article as |
Share |
YOUR ACCOUNT
YOUR ORDERS
SHOPPING BASKET
Items: 0
Total amount: € 0,00
HOW TO ORDER
YOUR SUBSCRIPTIONS
YOUR ARTICLES
YOUR EBOOKS
COUPON
ACCESSIBILITY
ORIGINAL ARTICLE
Journal of Neurosurgical Sciences 2022 April;66(2):117-24
DOI: 10.23736/S0390-5616.18.04555-1
Copyright © 2018 EDIZIONI MINERVA MEDICA
language: English
Clinical and radiological outcomes following open door laminoplasty: a single center evolution of the technique
Francesco SIGNORELLI ✉, Gianluca TREVISI, Federico BIANCHI, Carmelo ANILE, Angelo POMPUCCI
Unit of Neurosurgery and Neurotraumatology, Institute of Neurosurgery, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
BACKGROUND: The aim of the present study was to compare and describe clinical and radiological outcomes after two different variants of open door laminoplasty for cervical spondylotic myelopathy (CSM).
METHODS: Fifty-five patients underwent cervical laminoplasty for CSM. Between 2005 to 2009, 32 patients underwent open-door laminoplasty (Group A) performed with a monolateral exposure with contralateral “green stick” laminar fracture. A technical variant consisting in bilateral exposure, spinous process removal and symmetrical muscular closure was applied in the other 23 (Group B), from 2009 to 2016. A retrospective analysis of surgical results between the two groups was performed.
RESULTS: In group B, the mean operative time was longer, and the mean volume of intraoperative blood loss was much higher than in group A. Both differences were not significant (P=0.1601 and P=0.0884, respectively). The average hospitalization was non-significantly longer in group B (7.3±1.8 vs. 6.5±1.6 d; P=0.0947). Postoperatively, axial neck pain was more severe in group A at last follow-up than preoperatively (P>0.05). mJOA scores and Nurick grades improved significantly in both groups at last follow-up; in group A, the mean recovery rates were 41.5% by mJOA scores and 29.4% by Nurick grades, whereas in group B they were 52.7% and 36.8%, respectively.
CONCLUSIONS: Applying some few variations to a standard monolateral approach, although slightly more time and blood consuming, could reduce the incidence of long-term axial symptoms and, in our experience, are not burdened by worsening of outcomes. A prospective, multicentric study with a longer follow-up should be conducted in order to confirm our findings.
KEY WORDS: Spinal cord diseases; Laminoplasty; Neurosurgery