PMID- 34911089
OWN - NLM
STAT- MEDLINE
DCOM- 20220818
LR  - 20220818
IS  - 2193-6323 (Electronic)
IS  - 2193-6315 (Print)
IS  - 2193-6315 (Linking)
VI  - 83
IP  - 5
DP  - 2022 Sep
TI  - Surgical Treatment of Multilevel Degenerative Cervical Myelopathy: Open-Door 
      Laminoplasty and Fixation via Unilateral Approach. A Feasibility Study.
PG  - 494-501
LID - 10.1055/s-0041-1739224 [doi]
AB  - OBJECTIVE:  We compared open-door laminoplasty via a unilateral approach and 
      additional unilateral lateral mass screw fixation (uLP) with laminectomy and 
      bilateral lateral mass screw fixation (LC) in the surgical treatment of 
      multilevel degenerative cervical myelopathy (mDCM). METHODS:  A retrospective 
      cohort analysis of 46 prospectively enrolled patients (23 uLP and 23 LC). The 
      minimum follow-up was 1 year. Neck and arm pains were evaluated with visual 
      analog scales and disability with the Neck Disability Index (NDI). Myelopathy was 
      rated with the modified Japanese Orthopaedic Association (mJOA) score. Cervical 
      sagittal parameters were measured on plain and functional X-ray films with a 
      specific software. The statistical significance was set at p < 0.05. Fusion was 
      defined as <2 degrees of intersegmental motion on flexion/extension radiographs. 
      RESULTS:  The two groups were similar in age and comorbidities. The mean 
      operation time and the mean hospital stay were shorter in the uLP group 
      (p = 0.015). The intraoperative blood loss did not exceed 200 mL in both groups. 
      At follow-up, the groups showed comparable clinical outcome data. The sagittal 
      profile did not deteriorate in either group. Fusion rates were 67% in the uLP 
      group and 92% in the LC group. No infections occurred in either group. In the LC 
      group, one patient developed a transient C5 palsy. Revision surgery was required 
      for a malpositioned screw (LC) and for one implant failure (uLP). CONCLUSION: 
       Laminoplasty and unilateral fixation via a unilateral approach achieved 
      comparable clinical and radiologic results with laminectomy and bilateral 
      fixation, despite a lower fusion rate. However, the surgical traumatization was 
      less.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Schmeiser, Gregor
AU  - Schmeiser G
AUID- ORCID: 0000-0002-2432-8276
AD  - Department of Spine Surgery, Schoen-Klinik Hamburg-Eilbek, Hamburg, Germany.
FAU - Bergmann, Janina Isabel
AU  - Bergmann JI
AD  - Department of Spine Surgery, Schoen-Klinik Hamburg-Eilbek, Hamburg, Germany.
FAU - Papavero, Luca
AU  - Papavero L
AUID- ORCID: 0000-0002-3664-8736
AD  - Department of Spine Surgery, Schoen-Klinik Hamburg-Eilbek, Hamburg, Germany.
FAU - Kothe, Ralph
AU  - Kothe R
AD  - Clinic for Spine Surgery, Schoen Clinic Hamburg Eilbek, Academic Hospital of the 
      Eppendorf University Medical Center, Hamburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20211215
PL  - Germany
TA  - J Neurol Surg A Cent Eur Neurosurg
JT  - Journal of neurological surgery. Part A, Central European neurosurgery
JID - 101580767
SB  - IM
MH  - Cervical Vertebrae/diagnostic imaging/surgery
MH  - Feasibility Studies
MH  - Humans
MH  - Laminectomy/methods
MH  - *Laminoplasty/methods
MH  - Paralysis
MH  - Postoperative Complications/surgery
MH  - Retrospective Studies
MH  - *Spinal Cord Diseases/diagnostic imaging/surgery
MH  - Treatment Outcome
PMC - PMC9381301
COIS- None declared.
EDAT- 2021/12/16 06:00
MHDA- 2022/08/19 06:00
PMCR- 2021/12/01
CRDT- 2021/12/15 20:14
PHST- 2021/12/16 06:00 [pubmed]
PHST- 2022/08/19 06:00 [medline]
PHST- 2021/12/15 20:14 [entrez]
PHST- 2021/12/01 00:00 [pmc-release]
AID - 203018st [pii]
AID - 10.1055/s-0041-1739224 [doi]
PST - ppublish
SO  - J Neurol Surg A Cent Eur Neurosurg. 2022 Sep;83(5):494-501. doi: 
      10.1055/s-0041-1739224. Epub 2021 Dec 15.