Research ArticleCervical Spine

Combining Laminoplasty With Artificial Disc Replacement for the Treatment of Cervical Spondylotic Myelopathy With Congenital Cervical Stenosis

Zhao-Quan Liu, Cheng-Ta Hsieh, Chih-Ta Huang, Szu-Kai Hsu, Jing-Jing Fang and Chih-Ju Chang
International Journal of Spine Surgery May 2023, 8475; DOI: https://doi.org/10.14444/8475

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    (A) Preoperative extension radial graphic, between line means C5 and C6 (index) Cobb angle. (B) Preoperative flexion radial graphic, between line means C5 and C6 (index) Cobb angle; therefore, preoperative range of motion = 4.3° + 4. 4° = 8.7°. (C) Postoperative 6-mo extension radial graphic, C5-C6 (index) Cobb angle. (D) Postoperative 6-mo flexion radial graphic, C5-C6 (index) Cobb angle, postoperative 6-mo range of motion; 4.4° + 2.9° = 7.3°.

  • Figure 2
    Figure 2

    (A) Preoperative lateral graphic, Cobb angle = 17.8°. (B) Postoperative 6-mo neutral lateral graphic, Cobb angle = 17.5°. (C) Preoperative sagittal T2-weighted magnetic resonance image.

  • Figure 3
    Figure 3

    (A) The Japanese Orthopedic Association (JOA) score significantly improved after surgery (P < 0.001). (B) The calculated spinal canal diameter significantly expanded after surgery (P < 0.001). (C) Each laminoplasty level canal expansion area. OSP, optimal symmetry plan; post-op, postoperative; pre-op, preoperative. *Statistically significant at P < 0.05.

  • Figure 4
    Figure 4

    Cobb angle at preoperative and postoperative 6 mo, 1 y, and 2 y. Each of them had no significant difference.

  • Figure 5
    Figure 5

    Index-level range of motion (ROM) at preoperative and postoperative 6 mo, 1 y, and 2 y; only postoperative 6 mo had difference than preoperative; After 2-y follow-up, the index-level ROM could preserve as preoperation.

  • Figure 6
    Figure 6

    Case 1. (A) Preoperative sagittal T2-weighted magnetic resonance image (MRI). (B) Postoperative 2-y sagittal T2-weighted MRI. (C and D) Postoperative 2-y extension and flexion view of cervical spine x-ray image: preservation of range of motion. (E) Preoperative bone window axial view at the C5-C6 level. (F) Postoperative 6-mo bone window axial view at C5-C6 level with an obviously expanded spinal canal.

  • Figure 7
    Figure 7

    Case 2. (A) Preoperative sagittal T2-weighted magnetic resonance imaging (MRI), C3-C4 and C5-C6 had anterior disc compression lesion. (B) Postoperative 2-y follow-up T2-weighted MRI, spinal canal expansion. (C and D) Postoperative 2-y extension and flexion x-ray images reveal preserved range of motion.

Tables

  • Table

    Patients’ demographics and surgery level.

    Category N = 39
    Age, y, mean ± SD49.49 ± 9.36
    Sex, n
     Male33
     Female6
    Body mass index, kg/m2, mean ± SD26.80 ± 3.00
    Smoke, n 20
    Diabetes mellitus, n 5
    No. of segments artificial disc replacement operated, n (%)
     C3-C43 (7.7%)
     C4-C513 (33.3%)
     C5-C619 (48.7%)
     C4-C5-C63 (7.7%)
     C5-C6-C71 (2.6%)
    No. of segments laminoplasty operated, n (%)
     C3-C4-C5-C626 (66.7%)
     C4-C5-C612 (30.8%)
     C3-C4-C51 (2.6%)

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Combining Laminoplasty With Artificial Disc Replacement for the Treatment of Cervical Spondylotic Myelopathy With Congenital Cervical Stenosis
Zhao-Quan Liu, Cheng-Ta Hsieh, Chih-Ta Huang, Szu-Kai Hsu, Jing-Jing Fang, Chih-Ju Chang
International Journal of Spine Surgery May 2023, 8475; DOI: 10.14444/8475
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