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  • Combined Laminoplasty and Posterior Fusion for Treatment of Cervical Spondylotic Myelopathy: Systematic Review of the Literature

    Final Number:

    Authors:
    Kelly Bridges; Lauren Nicole Simpson MD; Carli Bullis MD; Christina M. Sayama MD; Khoi Duc Than MD

    Study Design:
    Other

    Subject Category:
    Spine

    Meeting: Section on Disorders of the Spine and Peripheral Nerves Spine Summit- 2017

    Introduction: The authors describe a systematic literature review of laminoplasty in combination with posterior instrumented fusion for treatment of cervical spondylotic myelopathy (CSM).

    Methods: A US National Library of Medicine PubMed search was conducted for manuscripts pertaining to cervical laminoplasty and fusion for management of CSM. Several relevant studies were found for review, and manuscript bibliographies searched for additional references. The search was limited to human studies, English-language literature, and reports with more than 1 patient.

    Results: Combined laminoplasty and fusion was found to result in at least comparable, if not superior, neurological outcomes in specific patient populations with cervical spondylotic myelopathy. Japanese Orthopedic Association (JOA) scores, local kyphosis, and C2-C7 angle were reviewed in many manuscripts, and improvement in each of these categories was found with laminoplasty and fusion.

    Conclusions: The treatment of CSM necessitates an individualized approach based on pathoanatomical variation. Laminoplasty and fusion can be appropriately used for patients with CSM in the setting of local kyphotic deformity, ossification of the posterior longitudinal ligament, associated segmental instability, and need for strong stabilization.

    Patient Care: Utilization of laminoplasty for preservation of the posterior elements with concomitant fusion may provide benefit in this scenario, as well as other unexplored scenarios, and should be considered.

    Learning Objectives: By the conclusion of this session, participants should be able to understand the benefits of combined laminoplasty and fusion in the setting of cervical spondylotic myelopathy in various settings including local kyphotic deformity, Ossification of the Posterior Longitudinal Ligament (OPLL), and athetoid cerebral palsy.

    References: 1. Wang MC, Kreuter W, Wolfla CE, Maiman DJ, Deyo RA. Trends and variations in cervical spine surgery in the United States: Medicare beneficiaries, 1992 to 2005. Spine (Phila Pa 1976). 2009;34(9):955-961. 2. Seng C, Tow BP, Siddiqui MA, et al. Surgically treated cervical myelopathy: a functional outcome comparison study between multilevel anterior cervical decompression fusion with instrumentation and posterior laminoplasty. Spine J. 2013;13(7):723-731. 3. Dadashev V, Rodts Jr. G. Treatment of Disk and Ligamentous Diseases of the Cervical Youmans Neurological Surgery. Vol 3. USA: Elsevier; 2011:2859-2867. 4. Jandial R, Garfin S. Best Evidence for Spine Surgery: 20 Cardinal Cases. Philadelphia, USA: Elsevier; Saunders; 2012. 5. Highsmith JM, Dhall SS, Haid RW, Jr., Rodts GE, Jr., Mummaneni PV. Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion. J Neurosurg Spine. 2011;14(5):619-625. 6. Lawrence BD, Jacobs WB, Norvell DC, Hermsmeyer JT, Chapman JR, Brodke DS. Anterior versus posterior approach for treatment of cervical spondylotic myelopathy: a systematic review. Spine (Phila Pa 1976). 2013;38(22 Suppl 1):S173-182. 7. Uehara M, Takahashi J, Ogihara N, et al. Cervical pedicle screw fixation combined with laminoplasty for cervical spondylotic myelopathy with instability. Asian Spine J. 2012;6(4):241-248. 8. Song J, Mizuno J, Nakagawa H, Inoue T. Surgery for acute subaxial traumatic central cord syndrome without fracture or dislocation. J Clin Neurosci. 2005;12(4):438-443. 9. Miyamoto H, Maeno K, Uno K, Kakutani K, Nishida K, Sumi M. Outcomes of surgical intervention for cervical spondylotic myelopathy accompanying local kyphosis (comparison between laminoplasty alone and posterior reconstruction surgery using the screw-rod system). Eur Spine J. 2014;23(2):341-346. 10. Matsumura A, Yanaka K, Akutsu H, Noguchi S, Moritake T, Nose T. Combined laminoplasty with posterior lateral mass plate for unstable spondylotic cervical canal stenosis--technical note. Neurol Med Chir (Tokyo). 2003;43(10):514-519. 11. Demura S, Murakami H, Kawahara N, Kato S, Yoshioka K, Tsuchiya H. Laminoplasty and pedicle screw fixation for cervical myelopathy associated with athetoid cerebral palsy: minimum 5-year follow-up. Spine (Phila Pa 1976). 2013;38(20):1764-1769. 12. Chen Y, Wang X, Chen D, Miao J, Liao X, Yu F. Posterior hybrid technique for ossification of the posterior longitudinal ligament associated with segmental instability in the cervical spine. J Spinal Disord Tech. 2014;27(4):240-244. 13. Shikata J, Yamamuro T, Shimizu K, Saito T. Combined laminoplasty and posterolateral fusion for spinal canal surgery in children and adolescents. Clin Orthop Relat Res. 1990(259):92-99. 14. Raimondi AJ, Gutierrez FA, Di Rocco C. Laminotomy and total reconstruction of the posterior spinal arch for spinal canal surgery in childhood. J Neurosurg. 1976;45(5):555-560. 15. Iwasaki M, Kawaguchi Y, Kimura T, Yonenobu K. Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up. J Neurosurg. 2002;96(2 Suppl):180-189. 16. Ogawa Y, Chiba K, Matsumoto M, et al. Long-term results after expansive open-door laminoplasty for the segmental-type of ossification of the posterior longitudinal ligament of the cervical spine: a comparison with nonsegmental-type lesions. J Neurosurg Spine. 2005;3(3):198-204. 17. Iizuka H, Nakajima T, Iizuka Y, et al. Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome. J Neurosurg Spine. 2007;7(6):610-614. 18. Fehlings MG, Smith JS, Kopjar B, et al. Perioperative and delayed complications associated with the surgical treatment of cervical spondylotic myelopathy based on 302 patients from the AOSpine North America Cervical Spondylotic Myelopathy Study. J Neurosurg Spine. 2012;16(5):425-432. 19. Shamji MF, Cook C, Tackett S, Brown C, Isaacs RE. Impact of preoperative neurological status on perioperative morbidity associated with anterior and posterior cervical fusion. J Neurosurg Spine. 2008;9(1):10-16. 20. Suda K, Abumi K, Ito M, Shono Y, Kaneda K, Fujiya M. Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2003;28(12):1258-1262. 21. Chen Z, Liu B, Dong J, et al. Comparison of anterior corpectomy and fusion versus laminoplasty for the treatment of cervical ossification of posterior longitudinal ligament: a meta-analysis. Neurosurg Focus. 2016;40(6):E8.

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