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Clinical Outcome after Laminectomy without Fusion for Cervical Spondylotic Myelopathy

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DOI: 10.4236/ojmn.2015.52007    3,318 Downloads   3,883 Views  

ABSTRACT

Dorsal decompression in patients, presenting with cervical spondylotic myelopathy with no signs of instability, is a standard surgical option. Laminectomy or laminoplasty is applied to reduce the pressure on the myelon. The aim of this study was to evaluate the clinical outcome in a consecutive series of patients. This retrospective study included a total of 65 patients who underwent laminectomy or laminoplasty at a single or more levels, without fusion for cervical spondylotic myelopathy, during an 8-year period (2000-2007). The clinical data evaluation included pre- and postoperative patient history and neurological and surgical variables. The radiological assessment included MRI, CT, and plain anterior-posterior, lateral, and lateral flexion-extension X-rays. The mean follow-up time was 15 months. Improvement of gait disturbance was documented in 74% of the patients concerned. Radicular pain in the upper limbs (UL) and lower limbs (LL) improved in 87% and 50% of the patients, respectively. Sensory deficits improved in the UL and LL in 76% and 54%, respectively. Motor deficits improved in the UL and LL in 70% and 56% of the patients, respectively. Clinical deterioration after surgery was documented in one patient. Based on our results, laminectomy without fusion can be advocated as a safe and effective surgical strategy to treat cervical spondylotic myelopathy in patients without preoperative instability. In these patients, the occurrence of post-procedural clinical deterioration and instability was low, and overall improvement of neurological deficits and amelioration of radicular pain can be expected in a significant number of patients.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Woernle, K. , Marbacher, S. , Khamis, A. , Landolt, H. and Fandino, J. (2015) Clinical Outcome after Laminectomy without Fusion for Cervical Spondylotic Myelopathy. Open Journal of Modern Neurosurgery, 5, 41-48. doi: 10.4236/ojmn.2015.52007.

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