Evidence map›Paper›PMID 29296286›Full record

ArticleSurgical neurology international2017

Nursing review of cervical laminectomy and fusion.

Nancy E Epstein

Abstract read
In one paragraph

Article in Surgical neurology international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Nancy E EpsteinChief of Neurosurgical Spine/Education, NYU Winthrop Hospital, Mineola, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCervical radiiculopathy/nerve root compression, myelopathy/cord compression are variously attributed to stenosis/narrowing of the spinal canal [anterior/posterior (AP) to less than 10 mm is defined as absolute stenosis, and 13 mm as relative stenosis]. Additional pathology includes disc herniations, ossification of the posterior longitudinal ligament (OPLL), and ossification of the yellow ligament (OYL). Patients, typically over 60 years of age, may present with severe myeloradicular syndromes requiring multilevel laminectomies and posterior instrumented fusions.

methodsPatients typically first undergo magnetic resonance imaging (MRI) studies of the cervical spine that best demonstrate soft tissue pathology; spinal cord and/or nerve root compression in three dimensions (AP/coronal (front/back), lateral (side), and axial (cross section)). Computed tomography (CT) studies better define ossification/calcific changes contributing to stenosis, including OPLL and/or OYL.

resultsIf there is multilevel cervical pathology and an adequately preserved cervical lordosis (curvature with the neck), a cervical laminectomy may provide adequate cord/root decompression. Performed under intraoperative monitoring, the laminae (bones cover the back of the cervical spine), spinous processes (midline bony protuberant structures), and OYL may be directly removed. Posterior fusions, utilizing varying instrumentation/constructs may prevent reversal of the lordosis (kyphosis: curve angled forward) and re-tethering of the spinal cord.

conclusionsPatients with myeloradiculopathy (cord/root compression) and multilevel cervical stenosis attributed to disc herniations, OPLL, and/or OYL with an adequate lordosis may require multilevel laminectomy and an instrumented fusion.

Indexed as

CT imagesMR studiesmultilevel cervical laminectomymyelopathyposterior cervical fusionsradiculopathy

Identifiers

PMID29296286
PMCPMC5742911

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.