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Surgery of the Cervical Spine
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Care should be taken to avoid plunging instruments into the interlaminar space. If required, the ligamentum flavum is detached from the inferior lamina using a spatula, Kerrison punch or triple zero curette. Further laminotomy, laminectomy or laminoplasty are carried out as needed (Figure 3.4).
Complications necessitating surgical intervention following cervical laminoplasty
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Michael J. Moses, Amos Z. Dai, Themistocles S. Protopsaltis
In other cases, patients require revision surgery due to the inadequate opening of the lamina during the index procedure. The inadequate opening leads to neurological sequelae related to the compression of the spinal cord and exiting nerve roots. Patients may present with limb numbness and other myelopathic symptoms that may directly parallel their initial presenting signs. However, there may also be cases during which the patient presents with new neurological findings that differ from their presentation prior to the index procedure. The main goal when the patient presents following a laminoplasty procedure is to decompress the spinal cord and create additional space to ameliorate the neurologic symptoms.
The neck
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Laminoplasty This procedure (enlarging the spinal canal by lifting up the posterior elements of the vertebra – Figure 17.24) is indicated for spinal cord compression secondary to developmental spinal canal stenosis, continuous or mixed type of ossified posterior longitudinal ligament, multisegmental spondylosis associated with a narrow spinal canal and a distal type of cervical spondylotic amyotrophy with canal stenosis. Laminoplasty should be an option for younger patients. It is preferable to laminectomy because it can lessen postoperative kyphosis, instability and pain. With this procedure the central canal is decompressed but nerve root decompression can still easily be accomplished, addressing foraminal stenosis. However, the incidence of neck pain after laminoplasty is reported to be high, and this is one of the most discouraging complications despite the advantages. Although preservation of spinal mobility is one of the aims of laminoplasty, the range of motion after this procedure usually decreases significantly.
Cervical syringomyelia with caudal thoracic epidural lipomatosis: case report and literature review
Published in International Journal of Neuroscience, 2023
Anthony Michael Alvarado, Zihan Masood, Sarah Woodrow
In all 3 prior cases surgical treatment was pursued after conservative treatment failed. Various techniques were utilized including laminectomy, laminoplasty, and laminotomy with excellent clinical and radiographic outcomes [1, 2, 10]. Noteworthy findings from the 3 prior cases include male predominance (67%) and clinical improvement following spinal cord decompression (100%). More so, syringomyelia reduction or resolution was noted in all patients. Interestingly, the use of corticosteroids or obesity was not a known contributing factor (Table 1). In the case by Saez-Alegre and colleagues conservative treatment was pursued for 10 years as the patient experienced only minor sensory symptoms in the setting of polyneuropathy documented on electromyogram; however, the patient experienced worsening symptoms with radiographic syrinx progression necessitating surgical intervention [1]. This exemplifies the importance of clinical decision making regarding syringomyelia and associated EL, and that management must be individualized and consider neurologic manifestations. In the case presented by Tucer et al., imaging also revealed an arachnoid cyst at the level of the syrinx. In this case, it is difficulty in determining whether the arachnoid cyst caused the syrinx formation or if the presence of EL was the cause [10].
Development of a Retro-Odontoid pseudotumor in the absence of atlantoaxial instability or rheumatoid arthritis Post-Laminoplasty: case report
Published in British Journal of Neurosurgery, 2023
Amer A. Alomari, Hideki Shigematsu, Masato Tanaka, Sachiko Kawasaki, Keisuke Masuda, Yusuke Yamamoto, Yasuhito Tanaka
Laminoplasty is a common procedure mainly performed for cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament.9 Although many spinal surgeons have reported stable results with good clinical outcomes after laminoplasty over the past 10 years, laminoplasty is not a perfect procedure.10 In fact, several common complications can occur after laminoplasty, such as C5 nerve palsy and axial neck pain in the early postoperative phase, as well as loss of lordosis in the late postoperative phase.11,12 Additionally, some reports, although limited, have focused on revision surgery after laminoplasty.13 Of those reports, Matsumoto et al. firstly reported an ROP after cervical laminoplasty and performed revision surgery with posterior fusion.14
Pathogenesis, management strategies, and outcome of non-communicating extradural spinal arachnoid cyst (NEAC): a systematic review
Published in British Journal of Neurosurgery, 2023
Mohammad Shahidul Islam Khan, Nazmin Ahmed, Kanak Kanti Barua, Bipin Chaurasia, Atul Vats, Atul Goel
A total 21 patients reported through 13 publications related to NEAC (Table 1). The mean age of the cases was 27.18 years (range: 20 months − 51 years). Among those cases, 11 were male and 10 were female. Based on neuroimaging findings, cysts were most commonly found at dorsal (10 patients) and dorsolumbar region (9 patients). Congenital predisposition was the most common proposed aetiology (19 patients) followed by traumatic and back surgery. All of the cases have presentation with paraparesis with variable degree of sensory disturbance. Among those, loss of position and vibration sense was most common, associated anomalies were seen in three patients. During surgery, 12 patients underwent laminectomy whereas only one patient underwent additional fusion procedure. Two patients were treated with laminoplasty (either T saw laminoplasty or vascularized pedicled laminoplasty) and for others, management procedure was not mentioned.