Minimally Invasive Cervical Laminectomy for Cervical Spondylotic Myelopathy. 2018

Miner N Ross, and Donald A Ross
Department of Neurological Surgery, Oregon Health and Science University.

Cervical spondylotic myelopathy is a common cause of neurological disability, especially in aging populations. There are several approaches to decompress the cervical spinal cord, including anterior cervical discectomy and fusion, corpectomy and fusion, arthroplasty, posterior cervical laminectomy with or without fusion, and laminoplasty. Less well described is minimally invasive cervical laminectomy. The authors report their technique and results for minimally invasive cervical laminectomy. The authors describe in detail their surgical technique and results of 30 consecutive cases. Preoperative and postoperative modified Japanese Orthopaedic Association (mJOA) myelopathy scores were recorded. In total, 30 cases were included. Mean age was 69 years (range, 57-89 y). Twelve procedures were at C3-4, 4 at C4-5, 5 at C5-6, 4 at C7-T1, 3 at C3-4 and C4-5, 1 at C4-5 and C5-6, and 1 at C5-6 and C6-7. Mean preoperative mJOA score was 12.1 (range, 4-15). Average length of surgery was 142 minutes. Mean follow-up was 27 months (range, 3-64 mo). At 3 months, mean postoperative mJOA score was 14.0 (range, 5-17). Mean mJOA improvement of 1.9 was statistically significant (P<0.001). Seventeen patients had magnetic resonance imaging (MRI) available at 3 months postoperatively (5 patients had no MRI, 3 patients had MRI contraindications, and 5 are pending). No MRI findings led to further surgery. There were no durotomies and no wound infections. A single patient had an unexplained new neurological deficit that resolved over 6 months. Minimally invasive laminectomy for cervical myelopathy is safe and effective and may be an underutilized procedure.

UI MeSH Term Description Entries
D007796 Laminectomy A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots. Laminotomy,Laminectomies,Laminotomies
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002574 Cervical Vertebrae The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK. Cervical Spine,Cervical Spines,Spine, Cervical,Vertebrae, Cervical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D013118 Spinal Cord Diseases Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. Myelopathy,Spinal Cord Disorders,Myelopathies,Spinal Cord Disease,Spinal Cord Disorder
D055009 Spondylosis A degenerative spinal disease that can involve any part of the VERTEBRA, the INTERVERTEBRAL DISK, and the surrounding soft tissue. Cervical Spondylosis,Lumbarsacral Spondylosis,Spondylosis Deformans,Thoracic Spondylosis,Spondylosis, Cervical,Spondylosis, Lumbarsacral,Spondylosis, Thoracic

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