Long-Term Follow-Up After Cervical Laminectomy without Fusion for Cervical Spondylotic Myelopathy. 2022

Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland.

OBJECTIVE The objectives were to study the effect of cervical laminectomy without fusion on the incidence of further cervical surgeries, the risk for cervical misalignment, and current functional status. METHODS We retrospectively analyzed the clinical data of 340 patients who had undergone simple laminectomy for cervical spondylotic myelopathy (CSM) at Helsinki University Hospital between 2000 and 2011. RESULTS Forty-one patients (12.1%) had later undergone another cervical surgery during the follow-up of a mean of 8.5 years (maximum, 17.5 years). The most common indication for further surgery was residual stenosis at adjacent or other cervical levels (34%). Five patients (1%) required further surgery for correction of a sagittal balance problem. The mean Neck Disability Index was 28% at a median of 9.0 years after laminectomy. The mean EQ-5D (EuroQol 5 Dimension 3 Level) index score was 58.8 for patients and 77.2 for age-matched and gender-matched general population controls (P = 0.000), indicating patients' reduced health-related quality of life. Worse preoperative condition in the Nurick score was related to a lower (i.e., worse) EQ-5D score. In an additional arm of the study with radiographic imaging (40 patients), the mean change in sagittal alignment was 4.0° toward lordotic, and a newly developed kyphosis was found in 7.5% of patients. CONCLUSIONS Because CSM is a serious degenerative progressive condition resulting in decreased health-related quality of life even after surgical treatment, the low rate of corrective surgery needed for alignment issues per se indicates that simple laminectomy can be a viable treatment option in treating multilevel CSM.

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
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
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
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
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
D013123 Spinal Fusion Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed) Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses
D013128 Spinal Osteophytosis Outgrowth of immature bony processes or bone spurs (OSTEOPHYTE) from the VERTEBRAE, reflecting the presence of degenerative disease and calcification. It commonly occurs in cervical and lumbar SPONDYLOSIS. Osteophytosis, Spinal,Osteophytoses, Spinal,Spinal Osteophytoses
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

Related Publications

Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
January 2015, Surgical neurology international,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
January 2017, European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
June 2020, Global spine journal,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
April 1999, Neurosurgery,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
September 1976, Archives of neurology,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
March 2011, Clinical orthopaedics and related research,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
January 2013, European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
October 2018, Clinical spine surgery,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
June 1971, Proceedings of the Royal Society of Medicine,
Anni Rissanen, and Mathias Hämäläinen, and Johan Marjamaa, and Jari Siironen, and Seppo Koskinen, and Juho Konsti, and Jussi Numminen, and Anniina Koski-Palkén
November 1995, The Journal of bone and joint surgery. British volume,
Copied contents to your clipboard!