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Anales de la Facultad de Medicina

versión On-line ISSN 2301-1254

Resumen

VELASCO, Juan Manuel et al. Spondylotic Cervical Myelopathy; Clinical Results After Laminoplasty. Anfamed [online]. 2019, vol.6, n.1, pp.150-169.  Epub 01-Jun-2019. ISSN 2301-1254.  http://dx.doi.org/10.25184/anfamed2019v6n1a6.

Background:

To evaluate the clinical results in patients with cervical spondylotic myelopathy operated surgically in our service by means of “open door” laminoplasty.

Methods:

We performed a retrospective analysis of patients who underwent cervical spondylotic myelopathy by laminoplasty between 2010 and 2017. Of the 102 patients operated on, we lost 18 cases or the data were insufficient. Of the 84 cases, 56 male patients with an average age of 63 years were evaluated: association of the lumbar pole, time between symptomatology and surgery, sagittal balance, myelomalacia and clinical results using the Nurick scale and the modified JOA.

Results:

The most frequent area of laminoplasty was C3-C6 (70%). The preoperative JOA average was 10.6 and postoperative at 3 months of 14.5, obtaining a recovery rate using the Hirabayashi method of 61%. The preoperative Nurick averaged 3.08 and at 3 months of 1.2. 42 patients presented with MRI hyperintense signaling in T2. The recovery rate of JOA and Nurick was significantly higher in patients operated on less than 6 months after symptom onset. We note a high incidence of bipolar suffering (30%). There were no major complications, 2 presented transient paresis of C5, 1 patient presented seroma that required superficial drainage and 4 presented mild axial pain that they did not have prior to surgery.

Conclusions:

In our experience, open-door laminoplasty is a technique with very good clinical results and a low incidence of complications for the treatment of cervical spondylotic myelopathy. We note a significant association between the rate of recovery of the JOA and the period between symptoms and surgery. On the other hand, we did not find a significant association between the clinical result and the number of spaces released as well as the presence of marrow signal alterations.

Palabras clave : Cervical Spine; Mielophaty; Laminoplasty..

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