Abstract
Background
The clinical outcomes and radiographic changes of a one-stage procedure combining cervical laminoplasty and unilateral cervical foraminotomy for patients with coexisting cervical myelopathy and unilateral radiculopathy were evaluated.
Methods
Seven patients (two females and five males) with coexisting cervical myelopathy and unilateral cervical radiculopathy were included in this study. The mean age was 58.4 years (range 45–77 years). Cervical laminoplasty and unilateral cervical foraminotomy were performed on the recruited patients in a single stage. The quantitative clinical changes between the preoperative and 6-month postoperative assessment were analyzed using the Japanese Orthopedic Association (JOA) score, the JOA Cervical Myelopathy Evaluation Questionnaire (JOA-CMEQ), visual analog scale (VAS), and Neck Disability Index (NDI). Moreover, the preoperative and 6-month postoperative radiographic changes were assessed using the C2-7 angle and range of motion (ROM) between flexion and extension angle.
Results
There were significant differences in QOL in the JOA-CMEQ between the groups. Furthermore, the postoperative VAS values in the arms and hands generally improved, although not significantly, between the groups.
Conclusions
The aforementioned surgical procedure may be safe and efficient for patients with coexisting cervical myelopathy and radiculopathy.
This is a preview of subscription content, log in via an institution to check access.
Data availability
The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
References
Baba H, Chen Q, Uchida K, Imura S, Morikawa S, Tomita K (1996) Laminoplasty with foraminotomy for coexisting cervical myelopathy and unilateral radiculopathy. Spine (Phila Pa 1976) 21:196–202
Edwards CC II, Riew KD, Anderson PA, Hilibrand AS, Vaccaro AF (2003) Cervical myelopathy: current diagnostic and treatment strategies. Spine J 3:68–81
Epstein NE (2002) A review of laminoforaminotomy for the management of lateral and foraminal cervical disc herniations or spurs. Surg Neurol 57:226–233
Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA et al (2007) Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 32:2310–2317
Goto T, Ohata K, Takami T, Nishikawa M, Tsuyuguchi N, Morino M et al (2002) Hydroxyapatite laminar spacers and titanium miniplates in cervical laminoplasty. J Neurosurg 97:323–329
Hirabayashi K, Toyama Y, Chiba K (1999) Expansive laminoplasty for myelopathy in ossification of the longitudinal ligament. Clin Orthop Relat Res 359:35–48
Kihara SI, Umebayashi T, Hoshimaru M (2005) Technical improvements and results of open-door expansive laminoplasty with hydroxyapatite implants for cervical myelopathy. Neurosurg 57:348–356
Liu WJ, Hu L, Chou PH, Wang JW, Kan WS (2016) Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. Orthop Surg 8:425–431
Marcó del Pont F, Giovannini SJM, Ries Centeno T, Caffaratti G, Lorefice E, Cervio A (2021) Cervical laminoplasty with unilateral C4–5 foraminotomy: technical note and case series. Neurocir (English Ed) 32:224–230
Sakaura H, Hosono N, Mukai Y, Ishii T, Yoshikawa H (2003) C5 palsy after decompression surgery for cervical myelopathy: review of the literature. Spine (Phila Pa 1976) 28:2447–2451
Sasai K, Saito T, Akagi S, Kato I, Ohnari H, Iida H (2003) Preventing C5 palsy after laminoplasty. Spine (Phila Pa 1976) 28:1972–1977
Selvanathan SK, Beagrie C, Thomson S, Corns R, Deniz K, Derham C et al (2015) Anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of brachialgia: the Leeds spinal unit experience (2008–2013). Acta Neurochir (Wien) 157:1595–1600
Tani S, Isoshima A, Nagashima Y, Numoto RT, Abe T (2002) Laminoplasty with preservation of posterior cervical elements: surgical technique. Neurosurg 50:97–101
Wang T, Tian XM, Liu SK, Wang H, Zhang YZ, Ding WY (2017) Prevalence of complications after surgery in treatment for cervical compressive myelopathy: a meta-analysis for last decade. Med (United States) 96:e6421
Wang T, Wang H, Liu S, Ding WY (2017) Incidence of C5 nerve root palsy after cervical surgery. Med (United States) 96:1–14
Yamasaki Y, Takeuchi K, Numasawa T, Wada K, Itabashi T, Kumagai G et al (2021) Can prophylactic C4/5 foraminotomy prevent C5 palsy after cervical laminoplasty with and without posterior instrumented fusion with maximal expansion? Eur J Orthop Surg Traumatol 31:1037–1046
Yoshioka N, Takayama M, Kobayashi T, Murai N, Ioroi Y (2020) Neurological disturbance of the upper extremities after cervical laminoplasty: a morphological assessment focused on the intervertebral foramen. Spine (Phila Pa 1976) 45:E1549–E1555
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Research involving human participants and informed consent
The study was conducted ethically and in accordance with the World Medical Association Declaration of Helsinki. This study protocol was reviewed and approval by hospital ethics committee, approval number 106. Written informed consent was obtained from all participants.
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Spine—Other
Rights and permissions
About this article
Cite this article
Kawasaki, T., Takayama, M., Maki, Y. et al. Combined cervical laminoplasty and foraminotomy for coexistence of cervical myelopathy and unilateral radiculopathy: case series and preliminary results. Acta Neurochir 165, 789–795 (2023). https://doi.org/10.1007/s00701-023-05519-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-023-05519-4