Influence of Intervertebral Level of Stenosis on Neurological Recovery and Reduction of Neck Pain After Posterior Decompression Surgery for Cervical Spondylotic Myelopathy

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Satoshi Nori ◽  
Narihito Nagoshi ◽  
Ryoma Aoyama ◽  
Shinichi Ishihara ◽  
Kanehiro Fujiyoshi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Spondylotic Myelopathy ◽  
Neurological Recovery ◽  
Decompression Surgery ◽  
Posterior Decompression ◽  
Intervertebral Level

Diabetes Does Not Adversely Affect Neurological Recovery and Reduction of Neck Pain After Posterior Decompression Surgery for Cervical Spondylotic Myelopathy

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Satoshi Nori ◽  
Narihito Nagoshi ◽  
Kenji Yoshioka ◽  
Kenya Nojiri ◽  
Yuichiro Takahashi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Spondylotic Myelopathy ◽  
Neurological Recovery ◽  
Decompression Surgery ◽  
Posterior Decompression

scholarly journals Two Types of Laminoplasty for Cervical Spondylotic Myelopathy at Multiple Levels

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Shigeru Hirabayashi ◽  
Takashi Matsushita
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Spinal Canal Stenosis ◽  
Decompression Surgery ◽  
Pathological Changes ◽  
Posterior Decompression ◽  
Element Analysis ◽  
Pathological Analysis ◽  
Canal Stenosis ◽  
Multiple Levels

Based on the results from pathological analysis and computer simulations by means of finite element analysis that were reported before, the pathological changes of cervical spondylotic myelopathy (CSM) seem to begin at the posterolateral parts of the spinal cord, because the mechanical stress is mainly concentrated in these parts. With progression of the compression, the pathological changes become distributed to a wider area of the spinal cord. In patients with spinal canal stenosis, these changes spread to multiple levels of the cervical spine. Therefore, posterior decompression surgery at multiple levels such as cervical laminoplasty is thought to be reasonable.

Neurological recovery after posterior decompression surgery for anterior dural compression in paralytic spinal metastasis

2012 ◽  
Vol 132 (6) ◽  
pp. 765-771 ◽  
Author(s):  
So Kato ◽  
Takahiro Hozumi ◽  
Katsushi Takeshita ◽  
Taiji Kondo ◽  
Takahiro Goto ◽  
...  
Keyword(s):  
Spinal Metastasis ◽  
Neurological Recovery ◽  
Decompression Surgery ◽  
Posterior Decompression

scholarly journals Microendoscopic laminotomy versus conventional laminoplasty for cervical spondylotic myelopathy: 5-year follow-up study

2017 ◽  
Vol 27 (4) ◽  
pp. 403-409 ◽  
Author(s):  
Akihito Minamide ◽  
Munehito Yoshida ◽  
Andrew K. Simpson ◽  
Hiroshi Yamada ◽  
Hiroshi Hashizume ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Spondylotic Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Recovery Rates ◽  
Cervical Sagittal Alignment ◽  
Axial Neck Pain ◽  
Clinical And Radiological Results

OBJECTIVEThe goal of this study was to characterize the long-term clinical and radiological results of articular segmental decompression surgery using endoscopy (cervical microendoscopic laminotomy [CMEL]) for cervical spondylotic myelopathy (CSM) and to compare outcomes to conventional expansive laminoplasty (ELAP).METHODSConsecutive patients with CSM who required surgical treatment were enrolled. All enrolled patients (n = 78) underwent CMEL or ELAP. All patients were followed postoperatively for more than 5 years. The preoperative and 5-year follow-up evaluations included neurological assessment (Japanese Orthopaedic Association [JOA] score), JOA recovery rates, axial neck pain (using a visual analog scale), the SF-36, and cervical sagittal alignment (C2–7 subaxial cervical angle).RESULTSSixty-one patients were included for analysis, 31 in the CMEL group and 30 in the ELAP group. The mean preoperative JOA score was 10.1 points in the CMEL group and 10.9 points in the ELAP group (p > 0.05). The JOA recovery rates were similar, 57.6% in the CMEL group and 55.4% in the ELAP group (p > 0.05). The axial neck pain in the CMEL group was significantly lower than that in the ELAP group (p < 0.01). At the 5-year follow-up, cervical alignment was more favorable in the CMEL group, with an average 2.6° gain in lordosis (versus 1.2° loss of lordosis in the ELAP group [p < 0.05]) and lower incidence of postoperative kyphosis.CONCLUSIONSCMEL is a novel, less invasive technique that allows for multilevel posterior cervical decompression for the treatment of CSM. This 5-year follow-up data demonstrates that after undergoing CMEL, patients have similar neurological outcomes to conventional laminoplasty, with significantly less postoperative axial pain and improved subaxial cervical lordosis when compared with their traditional ELAP counterparts.

scholarly journals N-acetylaspartate in the motor and sensory cortices following functional recovery after surgery for cervical spondylotic myelopathy

2016 ◽  
Vol 25 (4) ◽  
pp. 436-443 ◽  
Author(s):  
Sandy Goncalves ◽  
Todd K. Stevens ◽  
Patricia Doyle-Pettypiece ◽  
Robert Bartha ◽  
Neil Duggal
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Time Course ◽  
Spinal Injury ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Neurological Recovery ◽  
Decompression Surgery ◽  
Control Subjects ◽  
Sensory Cortices

OBJECTIVE Cervical spondylotic myelopathy (CSM) is the most common cause of reversible spinal cord dysfunction in people over the age of 55 years. Following surgery for symptomatic CSM, patients demonstrate motor improvement early in the postoperative course, whereas sensory improvement can lag behind. The authors of the present study hypothesized that changes in the concentration of N-acetylaspartate (NAA) in the motor and sensory cortices in the brain would emulate the time course of neurological recovery following decompression surgery for CSM. Their aim was to compare and contrast how metabolite levels in the motor and sensory cortices change after surgery to reverse downstream spinal cord compression. METHODS Twenty-four patients with CSM and 8 control subjects were studied using proton MR spectroscopy (1H-MRS) images acquired on a 3.0-T Siemens MRI unit. The 1H-MRS data (TE 135 msec, TR 2000 msec) were acquired to measure absolute levels of NAA from the motor and sensory cortices in the cerebral hemisphere contralateral to the side of greater deficit at baseline in each subject. Data were also acquired at 6 weeks and 6 months following surgery. Control subjects were also evaluated at 6 weeks and 6 months following baseline data acquisition. Neurological function was measured in each subject at all time points using the Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA) questionnaire, and the American Spinal Injury Association (ASIA) neurological classification. RESULTS In the motor cortex of patients, NAA levels decreased significantly (p < 0.05) at 6 weeks and 6 months postsurgery compared with baseline levels. In the sensory cortex of patients, NAA levels decreased significantly (p < 0.05) only at 6 months after surgery compared with baseline and 6-week levels. No significant changes in NAA were found in control subjects. Clinical scores demonstrated significant (p < 0.05) motor recovery by 6 weeks, whereas sensory improvements (p < 0.05) appeared at only 6 months. CONCLUSIONS Findings suggest that metabolite changes in both the motor and sensory cortices mimic the time course of functional motor and sensory recovery in patients with CSM. The temporal course of neurological recovery may be influenced by metabolic changes in respective cortical regions.

Impact of Tobacco Smoking on Outcomes After Posterior Decompression Surgery in Patients With Cervical Spondylotic Myelopathy

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Narihito Nagoshi ◽  
Hitoshi Kono ◽  
Osahiko Tsuji ◽  
Ryoma Aoyama ◽  
Kanehiro Fujiyoshi ◽  
...  
Keyword(s):  
Tobacco Smoking ◽  
Cervical Spondylotic Myelopathy ◽  
Decompression Surgery ◽  
Posterior Decompression

scholarly journals Clinical Effects of Anterior Cervical Spondylolisthesis on Cervical Spondylotic Myelopathy After Posterior Decompression Surgery: A Retrospective Multicenter Study of 732 Cases

2020 ◽  
pp. 219256822096633
Author(s):  
Ken Ninomiya ◽  
Junichi Yamane ◽  
Ryoma Aoyama ◽  
Satoshi Suzuki ◽  
Yuta Shiono ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Cervical Spondylotic Myelopathy ◽  
Clinical Status ◽  
Decompression Surgery ◽  
Neutral Position ◽  
Clinical Effects ◽  
Posterior Decompression ◽  
Predisposing Factor ◽  
Japanese Orthopedic Association ◽  
Group A

Study Design: Multicenter retrospective study. Objectives: We aim to investigate features of cervical spondylotic myelopathy (CSM) associated with anterior cervical spondylolisthesis (ACS) during posterior decompression surgery. Methods: A total of 732 patients with CSM were enrolled, who underwent posterior decompression surgery between July 2011 and November 2015 at 17 institutions. The patients with ACS (group A), defined as an anterior slippage of ≥2 mm on plain radiographs, were compared with those without ACS (group non-A). Also, the characteristics of patients with ACS progression (group P), defined as postoperative worsening of ACS ≥2 mm or newly developed ACS, were investigated. Moreover, kyphosis was defined as C2-C7 angle in neutral position ≤−5°. The Japanese Orthopedic Association (JOA) scoring system was used for clinical evaluation. Results: Group A consisting of 62 patients (8.5%) had worse preoperative clinical status but comparable surgical outcomes to group non-A. Furthermore, ACS was associated with greater age, and the degree of slippage did not affect myelopathy grades. Seventeen patients (2.3%) were observed in group P, and preoperative ACS was a significant predisposing factor for the progression without clinical impact. Among the patients in group A, preoperative cervical kyphosis was a risk factor for lower JOA recovery rate. Conclusions: Although the presence of ACS increases the risk of postoperative progression, it is not a contraindication for posterior decompression. However, surgeons need to consider the indication of fusion surgery for the patients who have ACS accompanied by kyphosis because of the poor surgical outcomes.

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