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Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy

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Summary

Eighteen patients with spondylotic myeloradiculopathy who had undergone expansive laminoplasty after anterior cervical fusion were reviewed. The average period from the initial to the second operation was 7.8 years. Excellent neurological improvement occurred in 4 patients, good in 6, fair in 4 and poor in 4. Radiographs at the time of the second operation showed spinal canal stenosis in 11, and 12 showed dynamic spinal canal stenosis immediately above the fused area. A narrow spinal canal adds to the risk of recurrence. When spinal stenosis is treated by anterior cervical fusion, additional laminoplasty should be carried out to prevent structural compromise occurring adjacent to the fused vertebrae.

Résumé

On a revu 18 patients atteints de myéloradiculopathie vertébrale et ayant subi, après fusion cervicale, une laminoplastie expansive complémentaire. Il y avait 11 hommes et 7 femmes. L'intervalle moyen entre les deux opérations était de 7,8 ans (de 1 à 33 ans). L'amélioration neurologique a été excellente chez quatre malades, bonne chez six, moyenne chez quatre et nulle chez quatre. Sur les radiographies faites au moment de la seconde opération, une sténose du canal rachidien était visible chez 11 patients et 12 montraient une sténose dynamique du canal rachidien immédiatement au dessus des zones fusionnées. On sait qu'un canal rachidien étroit comporte un risque de récidive. Lorsqu'on pratique une arthrodèse cervicale antérieure chez un patient porteur d'une telle sténose, on devrait réaliser une laminoplastie complémentaire chaque fois que la structure rachidienne apparait compromise à un niveau adjacent à la fusion vertébrale.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Fukui Medical School, Shimoaizuki 23, Matsuoka, 910-11, Fukui, Japan

    H. Baba, N. Furusawa & S. Imura

  2. Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Kanazawa, Japan

    N. Kawahara & K. Tomita

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  1. H. Baba
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  2. N. Furusawa
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  3. S. Imura
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  4. N. Kawahara
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  5. K. Tomita
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Baba, H., Furusawa, N., Imura, S. et al. Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy. International Orthopaedics 18, 1–5 (1994). https://doi.org/10.1007/BF00180168

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