gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Decompressive laminectomy and dorsal pedicle screw fixation for multilevel cervical spondylotic myelopathy: A clinical evaluation

Meeting Abstract

  • E. Kogias - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
  • C. Scholz - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
  • R. Sircar - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
  • C. Scheiwe - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
  • J.H. Klingler - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland
  • U. Hubbe - Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Deutschland

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.03.06

DOI: 10.3205/12dgnc192, URN: urn:nbn:de:0183-12dgnc1928

Published: June 4, 2012

© 2012 Kogias et al.
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Outline

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Objective: Decompressive laminectomy and transpedicular instrumentation of the cervical spine represents a widely accepted though demanding operative strategy in cases of multilevel cervical spondylosis. We report our experience with this technique. This study aims to evaluate the clinical outcome, to demonstrate the intra- and postoperative complications of this technique, as well as to detect potential drawbacks.

Methods: 53 consecutive patients (45 male, 8 female, mean age 63,5 years) suffering from extensive cervical spondylotic myelopathy underwent multilevel decompressive laminectomy and posterior instrumentation. A total of 323 pedicle screws were placed. A C-arm-based three-dimensional spinal navigation was used in 42 cases. Medical records and radiological findings were retrospectively reviewed. Follow-up varied from 2 months to 6 years.

Results: In 28 cases symptoms of myelopathy improved or remained unchanged. Major intraoperative complications did not occur. Navigation assisted screw placement was successful in 320 of 323 screws. Dural tear occurred in 2 cases and inaccurate screw placement in another 2 cases. We had the following postoperative complications: 3 cerebrospinal fluid fistulas, wound infection/seroma in 3 cases and secondary instrumentation failure in 4 cases. The majority of new neurological deficits (15 cases) were attributed to transient accentuation of myelopathy or root tension due to dorsal cord shift after laminectomy.

Conclusions: Decompressive laminectomy and dorsal transpedicular instrumentation of the cervical spine is a demanding surgical technique. The use of computer-assisted spinal navigation facilitates screw placement. However the occurrence of transient accentuation of myelopathy or new motor deficit remains respectable.