CERVICAL LAMINECTOMY WITHOUT STABILIZATION FOR CERVICAL SPONDYLOTIC MYELOPATHY - A SAFE AND EFFECTIVE OPTION?
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Keywords
Cervical Myelopathy, Laminectomy without stabilization, Clinical Outcome
Abstract
Introduction-Posterior decompression of the cervical spine without stabilization is an effective treatment option for cervical spondylotic myelopathy in elderly without cervical instability. Laminectomy decompresses the spinal cord by enabling cord fall back. However, the debate as to consider fusion or not, is constant. In this study we aim to assess the clinical outcome of posterior laminectomy without stabilization in elderly patients with cervical spondylotic myelopathy.
Methods-This is a prospective study conducted on 45 patients with cervical spondylotic myelopathy who underwent posterior laminectomy without fusion between 2023 Jan and 2024 Jan. All patients were followed up for a period of one year. Outcome parameters included sensory and motor improvement, assessment of radiculopathy, gait assessment and improvement of spasticity.
Results- Gait disturbance improved in 25 (83%) patients. A total improvement of sensory loss in the LL was seen in 19 cases (68%). Overall improvement of motor deficits was observed in the Upper Limb in 18 Patients (69%) and in the Lower Limb 14 Patients (60%). A total improvement of radicular pain was documented in 16 patients (72%) in upper limb and 6 (60%) in the lower limb.
Conclusion-In older patients without preoperative instability or cervical spine deformity, laminectomy without fusion can be recommended as a safe and successful surgical approach to treat cervical spondylotic myelopathy. Post-operative complications such as neurological deterioration and morbidity are reasonably low. In a significant number of patients, overall improvement of neurological deficits and amelioration of radicular pain can be expected.
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Dr. Amaresh C P
MBBS, MS Orthopaedics, DNB Orthopaedics, Fellowship in Spine Surgery
Dr. Nitish Sharma
MBBS, MS Orthopaedics
Dr. Amit Mundaganur
MBBS, MS Orthopaedics
Dr Hemanth DR
MBBS, MS Orthopaedics, Fellowship in Arthroplasty
Dr Arunkumar PM
MBBS, MS Orthopaedics, Fellowship in Advanced Orthopaedic Trauma
Dr Karthik Sagar S
MBBS, MS Orthopaedics, Fellowship in Arthroplasty
Dr Vaikunt G Nair
MBBS, Junior Resident in Orthopaedics