ArticleCureus2024
Evaluation of Postoperative Kyphotic Changes in Patients Who Underwent Cervical Laminectomy.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe stenosis of the cervical canal due to spondylotic changes is one of the common causes of spinal cord compression. Without adequate treatment, it results in progressive neurological deterioration. However, despite the wide acceptance of newer techniques, such as laminoplasty and laminectomy with fusion, in most situations, especially in resource-constraint situations, the role of laminectomy alone is pertinent. The following study reviews the effectiveness and safety of laminectomy alone in patients with cervical spondylotic myelopathy.
methodsA retrospective cohort study was conducted at Par Private Hospital, Erbil, including 46 patients diagnosed with cervical canal stenosis. All patients underwent laminectomy without fusion or laminoplasty, and postoperative outcomes were assessed using the modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI), and radiographic evaluations of cervical alignment. The relationship between preoperative and postoperative cervical alignment, kyphosis progression, and clinical outcomes was analyzed.
resultsMost patients showed significant neurological improvement in accordance with the improvement of scores of both mJOA and NDI. Among them, radiographic kyphosis progression occurred in 40% of patients, which was not associated with clinical deterioration. This showed a remarkable correlation between preoperative cervical alignment and postoperative outcomes, with R² = 0.733 and p < 0.001. No major complications like C5 palsy or wound infection were recorded throughout the follow-up period.
conclusionLaminectomy alone constitutes a proper and safe surgical alternative for cervical canal stenosis, especially in resource-poor countries. Although kyphosis progression occurred in some cases, there was no clinical impairment. Careful selection of patients by preoperative alignment is important for favorable outcomes. Comparing laminectomy alone with other techniques in longer follow-up will provide the final result in larger, multi-institutional groups.
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