Cervical laminectomy for the treatment of cervical degenerative myelopathy

View More View Less
  • 1 Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa;
  • | 2 Department of Neurosurgery, University of Medicine and Dentistry of New Jersey—New Jersey Medical School, Newark, New Jersey;
  • | 3 Division of Neurological Surgery, University of Alabama, Birmingham, Alabama;
  • | 4 Departments of Orthopaedic Surgery and
  • | 11 Neurological Surgery, University of Wisconsin, Madison, Wisconsin;
  • | 5 Department of Neurosurgery, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts;
  • | 6 Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles, California;
  • | 7 Department of Neurological Surgery, Neurological Institute, Columbia University, New York, New York;
  • | 8 Department of Neurosurgery, University of California at San Francisco, California;
  • | 9 Department of Neurosurgery, Mount Sinai School of Medicine, New York, New York; and
  • | 10 Department of Orthopaedic Surgery, Milton S. Hershey Medical Center, Pennsylvania State College of Medicine, Hershey, Pennsylvania
Restricted access

Purchase Now

USD  $45.00

Spine - 1 year subscription bundle (Individuals Only)

USD  $376.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
Print or Print + Online

Object

The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminectomy for the treatment of cervical spondylotic myelopathy (CSM).

Methods

The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminectomy and CSM. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I–III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons.

Results

Laminectomy has improved functional outcome for symptomatic cervical myelopathy (Class III). The limitations of the technique are an increased risk of postoperative kyphosis compared to anterior techniques or laminoplasty or laminectomy with fusion (Class III). However, the development of kyphosis may not necessarily to diminish the clinical outcome (Class III).

Conclusions

Laminectomy is an acceptable therapy for near-term functional improvement of CSM (Class III). It is associated with development of kyphosis, however.

Abbreviations used in this paper:

ACD = anterior cervical discectomy; CSM = cervical spondylotic myelopathy; ROM = range of motion.

Spine - 1 year subscription bundle (Individuals Only)

USD  $376.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $612.00
  • 1

    Adams CB, & Logue V: Studies in cervical spondylotic myelopathy. 3. Some functional effects of operations for cervical spondylotic myelopathy. Brain 94:587594, 1971

    • Search Google Scholar
    • Export Citation
  • 2

    Arnasson O, , Carlsson CA, & Pellettieri L: Surgical and conservative treatment of cervical spondylotic radiculopathy and myelopathy. Acta Neurochir (Wien) 84:4853, 1987

    • Search Google Scholar
    • Export Citation
  • 3

    Arnold H, , Feldmann U, & Missler U: Chronic spondylogenic cervical myelopathy. A critical evaluation of surgical treatment after early and long-term follow-up. Neurosurg Rev 16:105109, 1993

    • Search Google Scholar
    • Export Citation
  • 4

    Batzdorf U, & Batzdorff A: Analysis of cervical spine curvature in patients with cervical spondylosis. Neurosurgery 22:827836, 1988

  • 5

    Benzel EC, , Lancon J, , Kesterson L, & Hadden T: Cervical laminectomy and dentate ligament section for cervical spondylotic myelopathy. J Spinal Disord 4:286295, 1991

    • Search Google Scholar
    • Export Citation
  • 6

    Bishara SN: The posterior operation in treatment of cervical spondylosis with myelopathy: a long-term follow-up study. J Neurol Neurosurg Psychiatry 34:393398, 1971

    • Search Google Scholar
    • Export Citation
  • 7

    Carol MP, & Ducker TB: Cervical spondylitic myelopathies: surgical treatment. J Spinal Disord 1:5965, 1988

  • 8

    Casotto A, & Buoncristiani P: Posterior approach in cervical spondylotic myeloradiculopathy. Acta Neurochir (Wien) 57:275285, 1981

  • 9

    Ebersold MJ, , Pare MC, & Quast LM: Surgical treatment for cervical spondylitic myelopathy. J Neurosurg 82:745751, 1995

  • 10

    Epstein JA, , Janin Y, , Carras R, & Lavine LS: A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years. Acta Neurochir (Wien) 61:89104, 1982

    • Search Google Scholar
    • Export Citation
  • 11

    Fager CA: Results of adequate posterior decompression in the relief of spondylotic cervical myelopathy. J Neurosurg 38:684692, 1973

  • 12

    Gonzalez-Feria L, & Peraita-Peraita P: Cervical spondylotic myelopathy: a cooperative study. Clin Neurol Neurosurg 78:1933, 1975

  • 13

    Gorter K: Influence of laminectomy on the course of cervical myelopathy. Acta Neurochir (Wien) 33:265281, 1976

  • 14

    Gregorius FK, , Estrin T, & Crandall PH: Cervical spondylotic radiculopathy and myelopathy. A long-term follow-up study. Arch Neurol 33:618625, 1976

    • Search Google Scholar
    • Export Citation
  • 15

    Guidetti B, & Fortuna A: Long-term results of surgical treatment of myelopathy due to cervical spondylosis. J Neurosurg 30:714721, 1969

    • Search Google Scholar
    • Export Citation
  • 16

    Guigui P, , Benoist M, & Deburge A: Spinal deformity and instability after multilevel cervical laminectomy for spondylotic myelopathy. Spine 23:440447, 1998

    • Search Google Scholar
    • Export Citation
  • 17

    Hamanishi C, & Tanaka S: Bilateral multilevel laminectomy with or without posterolateral fusion for cervical spondylotic myelopathy: relationship to type of onset and time until operation. J Neurosurg 85:447451, 1996

    • Search Google Scholar
    • Export Citation
  • 18

    Ishida Y, , Suzuki K, , Ohmori K, , Kikata Y, & Hattori Y: Critical analysis of extensive cervical laminectomy. Neurosurgery 24:215222, 1989

  • 19

    Jeffreys RV: The surgical treatment of cervical myelopathy due to spondylosis and disc degeneration. J Neurol Neurosurg Psychiatry 49:353361, 1986

    • Search Google Scholar
    • Export Citation
  • 20

    Kaminsky SB, , Clark CR, & Traynelis VC: Operative treatment of cervical spondylotic myelopathy and radiculopathy. A comparison of laminectomy and laminoplasty at five year average follow-up. Iowa Orthop J 24:95105, 2004

    • Search Google Scholar
    • Export Citation
  • 21

    Kaptain GJ, , Simmons NE, , Replogle RE, & Pobereskin L: Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg 93:199204, 2000

    • Search Google Scholar
    • Export Citation
  • 22

    Kato Y, , Iwasaki M, , Fuji T, , Yonenobu K, & Ochi T: Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament. J Neurosurg 89:217223, 1998

    • Search Google Scholar
    • Export Citation
  • 23

    Matsunaga S, , Sakou T, & Nakanisi K: Analysis of the cervical spine alignment following laminoplasty and laminectomy. Spinal Cord 37:2024, 1999

    • Search Google Scholar
    • Export Citation
  • 24

    Mikawa Y, , Shikata J, & Yamamuro T: Spinal deformity and instability after multilevel cervical laminectomy. Spine 12:611, 1987

  • 25

    Miyazaki K, & Kirita Y: Extensive simultaneous multisegment laminectomy for myelopathy due to the ossification of the posterior longitudinal ligament in the cervical region. Spine 11:531542, 1986

    • Search Google Scholar
    • Export Citation
  • 26

    Nurick S: The natural history and the results of surgical treatment of the spinal cord disorder associated with cervical spondylosis. Brain 95:101108, 1972

    • Search Google Scholar
    • Export Citation
  • 27

    Perez-Lopez C, , Isla A, , Alvarez F, , Sarmiento MA, , Garcia-Raya P, & Perez-Alvarez M: [Efficacy of arthrodesis in the posterior approach of cervical myelopathy: comparative study of a series of 36 cases.]. Neurocirugia (Astur) 12:316323, 2001. (Span)

    • Search Google Scholar
    • Export Citation
  • 28

    Phillips DG: Surgical treatment of myelopathy with cervical spondylosis. J Neurol Neurosurg Psychiatry 36:879884, 1973

  • 29

    Yonenobu K, , Fuji T, , Ono K, , Okada K, , Yamamoto T, & Harada N: Choice of surgical treatment for multisegmental cervical spondylotic myelopathy. Spine 10:710716, 1985

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1400 254 35
Full Text Views 192 39 4
PDF Downloads 226 46 10
EPUB Downloads 0 0 0