| Restrictive Use of Cervical Noninstrumented Laminectomy |
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Sung Wun Jung, M.D., Tae Wan Kim, M.D., Kwan Ho Park, M.D., Moon Pyo Chi, M.D., Jae O Kim, M.D., and Jung Chul Kim, M.D. |
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Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea |
| Restrictive Use of Cervical Noninstrumented Laminectomy |
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Sung Wun Jung, M.D., Tae Wan Kim, M.D., Kwan Ho Park, M.D., Moon Pyo Chi, M.D., Jae O Kim, M.D., and Jung Chul Kim, M.D. |
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| Abstract |
Objective: The cervical laminectomy is a one of the method for treating multilevel spondylotic radiculopathy when cervical lordosis has been preserved and is indicated in patients with dorsal spinal cord compression. But, the cervical decompressive laminectomy without fusion procedure has a high risk of postoperative kyphotic deformity. Kyphotic deformity is relative to the clinical outcome. This study was designed to analyze the clinical and radiological outcomes and to present the restrictive use of cervical noninstrumented laminectomy.
Methods: From January 1996 to December 2001, we were operated forty three patients by cervical laminectomy. Among them, twelve patients were excluded because of less than three years follow up. Mean follow-up periods were 46 months. We measured the lordotic angle, angulation and subluxation (displacement of vertebral body on dynamic view) in all thirty one patients. The radiological change and the clinical outcome were taken for comparison with the patients' preoperative status. We prescribed the selected patients group which had the condition not occured radiological deformity as follows ① preservation of preoperative lordotic curve, ② less than three levels of laminectomy, ③ not involved C2 lamina.
Results: Four patients recurred symptoms such as pain and weakness and five patients appeared postoperative deformity. All four symptom recurred patients occured radiological deformity. But, no significant change in kyphotic angle and no instability (subluxation and angulation) occurred in the selected 13 patients. Their radiological change was within acceptable ranges. The clinical outcomes also improved compared to the patients' preoperative status, which was analyzed by using modified Macnab's criteria and the Cooper Scale.
Conclusion: Restrictive cervical laminectomy had no occurrence of radiological deformity in selected patients group as follows: ① preservation of preoperative lordotic curve, ② less than 3 levels of laminectomy, ③ not involved C2 lamina when other operative methods were applied with difficulty. |
| Keywords:
Cervical․Laminectomy․Radiological deformity․Follow-up |
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