Does developmental canal stenosis influence surgical results of bilateral open-door laminoplasty for cervical spondylotic myelopathy?

Clinical article

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Object

The purpose of this study was to investigate the prevalence of developmental canal stenosis in patients with cervical spondylotic myelopathy (CSM), and the correlation between surgical results and degree of developmental canal stenosis.

Methods

A total of 112 patients who eventually had surgical treatment for CSM were evaluated. Male patients whose sagittal spinal diameter was < 14 mm and females whose sagittal diameter was < 13 mm even at one level were classified as having developmental canal stenosis. Two groups of patients were used in this study; the “positive” group (57 cases) included patients with developmental canal stenosis preoperatively, whereas the “negative” group (55 cases) excluded such patients. Lateral functional radiographs obtained in patients in the 2 groups were compared for range of motion and clinical results.

Results

Developmental canal stenosis was found in 50.9% of all cases. Based on clinical results, there was no significant difference between the 2 groups.

Conclusions

Patients with CSM showed a high incidence of preoperative developmental canal stenosis. However, there were no significant differences in clinical results between patients with and without this disorder. These results indicate that developmental canal stenosis is not a factor that influences surgical results.

Abbreviations used in this paper: AP = anteroposterior; CSM =cervical spondylotic myelopathy; JOA = Japanese Orthopaedic Association; ROM = range of motion.

Article Information

Address correspondence to: Hideki Shigematsu, M.D., Department of Orthopedic Surgery, Nara Medical University, Shijyou 840, Kashihara, Japan. email: shideki@naramedu.ac.jp.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Schematic showing the method used to measure the AP spinal canal diameter (arrows).

  • View in gallery

    Schematic showing measurement of the ROM, which is defined as the angle between C2 and C7 on lateral functional radiographs. The ROM was calculated as a + b.

References

1

Alaranta HHurri HHeliovaara MSoukka AHarju R: Flexibility of the spine: normative values of goniometric and tape measurements. Scand J Rehabil Med 26:1471541994

2

Dall'Alba PTSterling MMTreleaven JMEdwards SLJull GA: Cervical range of motion discriminates between asymptomatic persons and those with whiplash. Spine 26:209020942001

3

Hagen KBHarmsRingdahl KEnger NOHedenstad RMorten H: Relationship between subjective neck disorders and cervical spine mobility and motionrelated pain in male machine operators. Spine 22:150115071997

4

Higo MSakou TSuzuki YMatsumoto RItou HKozakura H: [Roentgenological study of the anteroposterior diameter in cervical developmental canal stenosis.]. Rinsho Seikei Geka 19:3613661984. (Jpn)

5

Hinck VCSachdev NS: Developmental stenosis of the cervical spinal canal. Brain 89:27361966

6

Hirabayashi KMiyakawa JSatomi KMayuyama TWakano K: Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine 6:3543641981

7

Kawakami MTamaki TIwasaki HYoshida MAndo MYamada H: A comparative study of surgical approaches for cervical compressive myelopathy. Clin Orthop Relat Res 381:1291362000

8

Kikuchi YBaba HTomita KUmeda S: [Radiographic studies of the cervical spine after expansive laminoplasty.]. Seikei Saigaigeka 34:1651701991. (Jpn)

9

Kokubun SSato TIshii YTanaka Y: Cervical myelopathy in Japan. Clin Orthop Relat Res 323:1291381996

10

Matsuzaki HHosono MKiuchi TToriyama S: Domelike expansive laminoplasty for the second cervical vertebra. Spine 14:119812031989

11

Murone I: The importance of the sagittal diameters of the cervical spinal canal in relation to spondylosis and myelopathy. J Bone Joint Surg Br 56:30361974

12

Okada KShirasaki NHayashi HOka SHosoya T: Treatment of cervical spondylotic myelopathy by enlargement of the spinal canal anteriorly, followed by arthrodesis. J Bone Joint Surg Am 73:3523641991

13

Omura FShirai YNakagawa SYamaguchi JFujisawa JOba T: [Cervical spine motion after expansive laminoplasty-open-door laminoplasty vs split spinous process method.]. Rinsho Seikei Geka 24:4534591989. (Jpn)

14

Payne EESpillane JD: The cervical spine: an anatomicopathological study of 70 specimens (using a special technique) with particular reference to the problem of cervical spondylosis. Brain 80:5715961957

15

Penning L: Normal movements of the cervical spine. AJR Am J Roentgenol 130:3173261978

16

Puglisi FRidi RCecchi FBonelli AFerrari R: Segmental vertebral motion in the assessment of neck range of motion in whiplash patients. Int J Legal Med 118:2352392004

17

Saunders RLBernini PMShirreffs TG JrReeves AG: Central corpectomy for cervcal spondylotic myelopathy: a consecutive series with longterm follow-up evaluation. J Neurosurg 74:1631701991

18

Shoda ESumi MKataoka OMukai HKurosaka M: Developmental and dynamic canal stenosis as radiologic factors affecting surgical results of anterior cervical fusion for myelopathy. Spine 24:142114241999

19

Sunago KKawai SOda YMatsuoka AKido KNomura K: [Postoperative radiographic evaluation of cervical laminoplasty (Hattori's method).]. Rinsho Seikei Geka 24:4454521989. (Jpn)

20

Yamashita TMiyano SYokogushi KIshii SNosaka T: [A multivariate analysis of factors affecting the surgical outcome of cervical spondylotic myelopathy.]. Seikei Geka 45:181518171994. (Jpn)

21

Ylinen JTakala EPKautiainen HNykanen MHakkinen APohjolainen T: Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic nonspecific neck pain. Eur J Pain 8:4734782004

22

Yonenobu K: Cervical radiculopathy and myelopathy: when and what can surgery contribute to treatment?. Eur Spine J 9:172000

23

Yonenobu KOkada KFuji TFujisawa KYamashita KOno K: Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine 11:8188231986

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