Long-term follow-up of clinical and radiological outcome after cervical laminectomy

被引:29
|
作者
van Geest, Sarita [1 ]
de Vormer, Anouk M. J. [1 ]
Arts, Mark P. [2 ]
Peul, Wilco C. [1 ,2 ]
Vleggeert-Lankamp, Carmen L. A. [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Neurosurg, NL-2300 RC Leiden, Netherlands
[2] Med Ctr Haaglanden, Dept Neurosurg, NL-2512 VA The Hague, Netherlands
关键词
Cervical laminectomy; Cervical myelopathy; Cervical medullary compression; Kyphosis; Spondylodesis; SPONDYLOTIC MYELOPATHY; COMPRESSION MYELOPATHY; RISK-FACTORS; SPINE; FUSION; DISKECTOMY; DYSPHAGIA; PROGNOSIS; SURGERY; SYSTEM;
D O I
10.1007/s00586-013-3089-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose To evaluate long-term clinical and radiological results of cervical laminectomy without adjuvant-instrumented fusion for degenerative spinal cord compression. Methods A retrospective follow-up study of patients in which clinical data (n = 207), questionnaires (n = 96) and fluoroscopy (n = 77) were reviewed. Results Postoperative perceived recovery was reported by 76 and 63 % of patients at 3 months and 9 years, respectively. Functional status remained unchanged. The incidence of kyphosis and segmental instability was 15 and 18 %, respectively, and occurred almost exclusively if preoperative lordosis was <20 degrees. Neither kyphosis nor segmental instability correlated to perceived recovery and no predisposing variables were identified. Conclusions Cervical laminectomy without adjuvant-instrumented fusion should be considered as a treatment for compressive degenerative cervical myelopathy in patients with a lordotic cervical spine without congenital deformities. Additional reconstructive correction of the cervical spine is only proven appropriate in selected cases.
引用
收藏
页码:S229 / S235
页数:7
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