Comparison of C5 nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation

doi:10.3969/j.issn.2095-4344.2015.53.005

Abstract

Abstract:

BACKGROUND: Laminoplasty and laminectomy are the most commonly used treatment methods for multilevel cervical spondylotic myelopathy, which is more common in elderly patients. C₅ nerve root palsy is the common postoprative complication after posterior cervical repair.

OBJECTIVE: To compare the incidence of C₅ nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation in repair of multilevel cervical spondylotic myelopathy.

METHODS: Totally 134 patients with multilevel cervical spondylotic myelopathy from August 2010 to December 2014 were enrolled, and then divided into laminoplasty group (n=45) and laminectomy group (n=89) owing to different ways of repair. Patients in the laminoplasty group were treated with laminoplasty with mini-titanium plate fixation, and patients in the laminectomy group were treated with laminectomy with internal fixation. C₅ nerve root palsy condition after repair was recorded and evaluated. The cervical lordosis angle (Cobb angle) and cervical curvature index were compared. The Japanese Orthopaedic Association score was used for neurological assessment.

RESULTS AND CONCLUSION: All patients in both groups were followed up for more than 6 months. There were no significant differences in cervical lordotic angle and cervical curvature index at the first week before and after the treatment between these two groups (P > 0.05). The Japanese Orthopaedic Association scores of patients after 6 months of treatment were significantly improved compared with that before treatment in these two groups (P < 0.05). There were 2 cases of C₅ nerve root palsy after the treatment of laminoplasty, the occurrence rate was 4% (2/45); there were 10 cases of C₅ nerve root palsy after the treatment of laminectomy, the occurrence rate was 11% (10/89); there was significant difference between these two groups (P < 0.05). These results suggest that compared with laminectomy fixation, the incidence of C₅ nerve root palsy was lower after the laminoplasty with mini-trianium plate fixation, which can be widely used in decompression repair treatment of multilevel cervical spondylotic myelopathy.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

CLC Number:

R318

Feng Da-peng, Xu Wei-bing,Zhao Zhi, Yuan Liang, Li Guang-can, Nan Feng, Li Zheng-wei. Comparison of C₅ nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(53): 8554-8553.

Figures/Tables 6

References

[1] Rhee JM, Basra S. Posterior surgery for cervical myelopathy: laminectomy, laminectomy with fusion, and laminoplasty. Asian Spine J. 2008; 2(2): 114-126.

[2] Sekhon LH. Posterior cervical decompression and fusion for circumferential spondylotic cervical stenosis: review of 50 consecutive cases. J Clin Neurosci. 2006;13(1): 23-30.

[3] Chiba K, Toyama Y, Matsumoto M, et al. Segmental motor paralysis after expansive open?door laminoplasty. Spine (Phila Pa 1976). 2002;27(19): 2108-2115.

[4] Sakanra H,Hosono N, Mukai Y, et al. C5 palsy after decompression surgery for cerviealmyelopathy. Spine. 2003; 21(1):2447-2451．

[5] Hashimoto M, Mochizuki M,Aiba A,et al. C5 palsy following anterior decompression and spinal fusion for cervical degenerative diseases．Eur Spine J. 2010;19(10):1702-1710．

[6] Cabraja M, Abbushi A, Koeppen D, et al. Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome. Neurosurg Focus. 2010;28(3):E15.

[7] Kanchiku T,Imajo Y,Suzuki H,et al. Results of surgical treatment of cervical spondylotic myelopathy in patients aged 75 years or more: a comparative study of operative methods. Arch Orthop Trauma Surg. 2014;134(8):1045-1050.

[8] Heller JG, Edwards CC 2nd, Murakami H, et al. Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy:an independent matched cohort analysis. Spine (Phila Pa 1976). 2001;26(12):1330-1336.

[9] Uchida K, Nakajima H, Sato R, et al. Cervical spondylotic myelopathy associated with kyphosis or sagittal sigmoid alignment: outcome after anterior or posterior decompression. J Neurosurg Spine. 2009;11(5):521-528.

[10] Suda K, Abumi K, Ito M, et al. Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2003;28(12): 1258-1262.

[11] Petraglia AL, Srinivasan V, Coriddi M, et al. Cervical lamino-plasty as a management option for patients with cervical spondy-lotic myelopathy: a series of 40 patients. Neurosurgery. 2010;67(2):272-277.

[12] Dimar JR 2nd, Bratcher KR, Brock DC, et al. Instrumented open-door laminoplasty as treatment for cervical myelopathy in 104 patients. Am J Orthop (Belle Mead NJ). 2009;38(7): E123-128.

[13] Woods BI, Hohl J, Lee J, et al. Laminoplasty versus laminectomy and fusion for multilevel cervical spondylotic myelopathy. Clin Orthop Relat Res. 2011;469(3): 688-695.

[14] Kang SH, Rhim SC, Roh SW, et al. Postlaminoplasty cervical range of motion: early results. J Neurosurg Spine. 2007;6(5): 386-390.

[15] Yeh KT,Yu TC,Chen IH,et al. Expansive open-door laminoplasty secured with titanium miniplates is a good surgical method for multiple-level cervical stenosis. J Orthop Surg Res. 2014;21;9:49.

[16] Miller JA,Lubelski D,Alvin MD,et al. C5 palsy after posterior cervical decompression and fusion: cost and quality-of-life implications. Spine J. 2014;14 (12):2854-2860.

[17] Epstein NE,Hollingsworth R.C5 Nerve root palsies following cervical spine surgery: A review. Surg Neurol Int. 2015; 6(Suppl 4):S154-163.

[18] Guzman JZ,Baird EO,Fields AC,et al. C5 nerve root palsy following decompression of the cervical spine: a systematic evaluation of the literature. Bone Joint J. 2014;96-B(7): 950-955.

[19] Satomi K, Nishu Y, Kohno T, et al. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine (Phila Pa 1976). 1994;19(5): 507-510.

[20] Imagama S, Matsuyama Y, Yukawa Y, et al. C5 palsy after cervical laminoplasty: a multicentre study. J Bone Joint Surg Br. 2010;92(3):393-400.

[21] Meng H,Fang X, Hao D, et al. Incidences of C5 nerve palsy after multi-segmental cervical decompression through different approaches．Nan Fang Yi Ke Da Xue Xue Bao. 2015;35(3):315-318.

[22] Gu Y, Cao P, Gao R, et al. Incidence and risk factors of C5 palsy following posterior cervical decompression: a systematic review. PLoS One. 2014;27;9(8):e101933.

[23] Sasai K, Saito T, Akagi S, et al. Preventing C5 palsy after laminoplasty. Spine(Phila Pa 1976). 2003;28(17):1972-1977.

[24] Hojo Y, Ito M, Abumi K, et al. A late neurological complication following posterior correction surgery of severe cervical kyphosis. Eur Spine J. 2011;20(6): 890-898.

[25] Nakashima H, Imagama S, Yukawa Y, et al. Multivariate analysis of C5 palsy incidence after cervical posterior fusion with instrumentation. J Neurosurg Spine. 2012;17(2): 103-110.

[26] Heller JG, Silcox DH 3rd, Sutterlin CE 3rd. Complications of posterior cervical plating. Spine (Phila Pa 1976). 1995;20(22): 2442-2448.

[27] Nobuyuki T, Li ZH, Ryoji A, et al. Paralysis of the arm after posterior decomp ression of the cervical sp inal cord: I. Anatomical investigation of the mechanism of paralysis. Eur Spine J. 1993;2 (4):191-196.

[28] Yamashita T, Yokogusu K, Yokozawa H,et al. C5 nerve palsyafter cervical laminoplasty: an analysis of three cases．Seikei Geka. 1996;47(3):1365-1369．

[29] Sodeyama T, Goto S, Mochizuki M,et al. Efect of deeompression enlargement laminoplasty for posterior shifting of the spinaleordSpine. 1999;24(2):1527-1531.

[30] Radcliff KE,Limthongkul W,Kepler CK,et al. Cervical laminectomy width and spinal cord drift are risk factors for postoperative C5 palsy. J Spinal Disord Tech. 2014;27(2): 86-92.

[31] Tsuzuki N, Abe R, Saiki K, et al. Extradural tethering effect as one mechanism of radiculopathy complicating posterior decompression of the cervical spinal cord. Spine. 1996;21(2): 203-211.

[32] Katsumi K,Yamazaki A,Watanabe K,et al.Analysis of C5 palsy after cervical open-door laminoplasty: relationship between C5 palsy and foraminal stenosis. J Spinal Disord Tech. 2013; 26(4):177-182.

Comparison of C₅ nerve root palsy after laminoplasty with mini-titanium plate fixation and laminectomy with internal fixation

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