Our Summary

Cervical spondylotic myelopathy (CSM) is a condition where the neck’s spinal cord gradually deteriorates, often requiring surgery to prevent worsening of the neurological symptoms. This study looked at the effectiveness of a new surgery technique called osteoligamentous decompression via hemilaminectomy (OLD).

The researchers compared this technique to another common surgery called laminoplasty. They examined the amount of space created in the spinal canal (which is crucial for relieving symptoms) with each technique and whether the patients’ symptoms improved after surgery.

In the study, they included 38 patients, half of whom underwent OLD and half had laminoplasty. Both groups had similar characteristics in terms of sex, age, the amount of space in their spinal canal before surgery, and the number of affected spinal levels.

The results showed that both techniques significantly increased the space in the spinal canal. However, the patients who had the OLD technique seemed to have a slightly greater increase in space. Importantly, the patients who underwent the OLD technique also showed a significant improvement in their symptoms after surgery.

In conclusion, this study suggests that the OLD technique can be as effective as laminoplasty in treating CSM. Not only does it create a similar amount of space in the spinal canal, but it also results in significant improvement in patients’ symptoms.

FAQs

  1. What is Cervical spondylotic myelopathy (CSM) and how is it typically treated?
  2. What is the osteoligamentous decompression via hemilaminectomy (OLD) technique and how does it compare to laminoplasty?
  3. What were the results of the study comparing the OLD technique and laminoplasty in treating CSM?

Doctor’s Tip

When undergoing spinal decompression surgery, it is important to follow your doctor’s post-operative care instructions carefully. This may include avoiding certain activities, wearing a brace, attending physical therapy sessions, and taking prescribed medications. By following these guidelines, you can help ensure a successful recovery and optimal results from the surgery.

Suitable For

Patients with cervical spondylotic myelopathy (CSM) who are experiencing neurological symptoms such as weakness, numbness, or coordination issues may be recommended for spinal decompression surgery using techniques such as OLD or laminoplasty. These patients may have a narrowing of the spinal canal in the neck region, leading to compression of the spinal cord and nerve roots.

Other types of patients who may be recommended spinal decompression surgery include those with herniated discs, spinal stenosis, degenerative disc disease, or other conditions causing compression of the spinal cord or nerve roots in the lumbar (lower back) or thoracic (mid-back) regions.

Ultimately, the decision to recommend spinal decompression surgery will depend on the specific condition, severity of symptoms, response to conservative treatments, and individual patient factors. Patients should consult with a spine specialist to determine the most appropriate treatment options for their specific situation.

Timeline

Before spinal decompression surgery, a patient may experience symptoms such as neck pain, numbness or weakness in the arms or legs, difficulty walking, and problems with coordination. These symptoms may worsen over time and can significantly impact the patient’s quality of life.

After spinal decompression surgery, the patient may initially experience some pain and discomfort as they recover from the procedure. However, as the healing process progresses, the patient should start to notice improvements in their symptoms. This may include reduced pain, improved mobility, and better function in the affected areas. Over time, the patient’s symptoms should continue to improve as they regain strength and function in their spine and surrounding nerves. With proper rehabilitation and follow-up care, the patient can expect to experience long-term relief from their CSM symptoms.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal decompression for cervical spondylotic myelopathy (CSM) include:

  1. What are the risks and potential complications associated with the OLD technique compared to laminoplasty?
  2. How long is the recovery time for each surgery technique and what can I expect during the recovery process?
  3. Will I need physical therapy or rehabilitation after surgery, and if so, for how long?
  4. What are the long-term outcomes and success rates of the OLD technique for treating CSM?
  5. Are there any specific criteria or factors that make a patient a better candidate for the OLD technique over laminoplasty?
  6. How soon after surgery can I expect to see improvement in my symptoms, and what should I do if my symptoms do not improve as expected?
  7. Are there any alternative treatments or non-surgical options for CSM that I should consider before deciding on surgery?
  8. How many times have you performed the OLD technique, and what is your experience and success rate with this procedure?
  9. Are there any lifestyle changes or precautions I should take after surgery to prevent further deterioration of the spinal cord?
  10. Can you provide me with any patient testimonials or references who have undergone the OLD technique for CSM?

Reference

Authors: Hernández-Durán S, Zafar N, Behme D, Momber M, Rohde V, Mielke D, Fiss I. Journal: Acta Neurochir (Wien). 2020 Sep;162(9):2069-2074. doi: 10.1007/s00701-020-04453-z. Epub 2020 Jun 25. PMID: 32583084