gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Laminoplasty as a safe and effective surgical procedure to treat cervical spinal canal stenosis

Meeting Abstract

Suche in Medline nach

  • M. Momber - Universitätsmedizin Göttingen, Klinik für Neurochirurgie
  • V. Rohde - Universitätsmedizin Göttingen, Klinik für Neurochirurgie
  • R. Martinez - Universitätsmedizin Göttingen, Klinik für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.03.07

DOI: 10.3205/12dgnc193, URN: urn:nbn:de:0183-12dgnc1934

Veröffentlicht: 4. Juni 2012

© 2012 Momber et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Concerning cervical spinal canal stenosis there still is a controversy regarding the optimal surgical method in terms of anterior or posterior approach. Anterior approaches are associated with wide variety of comorbidities such as lesions of vessels and structures located anterior from the spine. Additionally, adequate decompression of stenosis might require extensive surgery such as corpectomy. Posterior approaches including laminectomy and laminoplasty provide a safe way to decompress the spinal cord and nerve roots, are easy to perform and are associated with low rates of complications. The aim of our study was to analyse 85 consecutive patients who underwent laminoplasty for cervical spinal canal stenosis. We have retrospectively analysed neck pain, neurological status, surgical related complications pre- and postoperatively during follow-up.

Methods: From 2005 to 2011, laminoplasty was performed in 85 consecutive patients in our department for degenerative spinal canal stenosis. In median, the patients were 57 years old (range: 16–84). The male:female ratio was 3:1. Preoperatively we have performed cervical CT or MRI, in selected cases dynamic cervical x-rays. Postoperatively we have also performed CT-Scans for clinical assessment of pain. The visual analogue scale (VAS) was used. Laminoplasty was performed following the open-book-technique.

Results: All patients complained of neck pain. Radiculopathy was observed in 45,8% (39 / 85), paraesthesia was present in 57,6% (49 / 85), paresis in 29,4% (25 / 85). Myelopathy in terms of gait impairment and T2-weigthed MRI hyperintensive signal was observed in 57,6 % (49 / 85) of the patients. After surgery, an improvement of radiculopathy was seen in 24,7% of the patients (21 / 85). Paresis and paraesthesia improved in 24,7% (21 / 85) and 28,2% (24 / 85) of the patients respectively. Improvement of the gait could be observed in 29,4% of the patients (25 / 85). Regarding complications, epidural hematoma occurred in 3,5% (3 / 85) of the patients requiring surgical evacuation. Wound healing impairment was observed in one only case and could be successfully treated conservatively.

Conclusions: Our data strongly suggest that laminoplasty is a safe treatment for cervical spinal canal stenosis, with a low rate of surgical complications. It allows an optimal decompression of neural structures and reliable achievement of pain control avoiding instability during follow-up.