Our Summary

This study compared two types of surgery for degenerative cervical myelopathy (a condition where the spinal cord in the neck region deteriorates): one where a part of the spine is removed (laminectomy) and another where the same procedure is combined with fusion of the spine. The researchers used data from a Swedish spine registry, comparing 66 patients who underwent the combined procedure to 132 who just had the laminectomy.

They looked at several measures of health and wellbeing, such as the European Myelopathy Scale (a measure of spinal cord function), the Neck Disability Index (a measure of neck pain and related issues), the Numeric Rating Scale (another measure of neck pain), and the EQ-5D index (a measure of general health status). They assessed these measures at the start of the study and at 1 and 2 years after the surgeries.

The results showed that both groups improved significantly in the first year after surgery, with no further improvement between the first and second years. There were no major differences between the two groups, except that those who had the combined procedure had slightly more neck disability and pain after 2 years. However, these differences were small and may not be clinically significant.

Overall, the study suggests that both types of surgery are similarly effective in treating degenerative cervical myelopathy.

FAQs

  1. What are the two types of surgery compared in this study for degenerative cervical myelopathy?
  2. What health measures were evaluated in this study and when were they assessed?
  3. What were the key findings of the study regarding the effectiveness of the two types of surgeries?

Doctor’s Tip

A doctor might tell a patient considering spinal laminectomy that it is a common and effective procedure for conditions such as degenerative cervical myelopathy. They might also mention that while the surgery can improve symptoms and function in the short term, it is important to continue with post-operative care and follow-up appointments to ensure long-term success. Additionally, they might discuss the potential risks and benefits of the surgery, as well as any alternative treatment options that may be available.

Suitable For

Patients who have degenerative cervical myelopathy and are experiencing symptoms such as neck pain, weakness in the arms or legs, numbness or tingling, and difficulty walking or performing daily activities may be recommended spinal laminectomy. This procedure is typically considered for patients who have not responded to conservative treatments such as physical therapy, medications, and injections. However, the decision to undergo spinal laminectomy should be made on a case-by-case basis after consulting with a spine specialist.

Timeline

Before the spinal laminectomy:

  • Patient experiences symptoms of degenerative cervical myelopathy, such as neck pain, numbness, weakness, and difficulty walking.
  • Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis.
  • Patient consults with a spine surgeon to discuss treatment options.
  • Patient decides to undergo spinal laminectomy surgery.

After the spinal laminectomy:

  • Patient undergoes spinal laminectomy surgery to remove part of the spine to alleviate pressure on the spinal cord.
  • Patient is monitored in the hospital for a few days post-surgery.
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  • Patient experiences improvement in symptoms, such as reduced neck pain and improved function.
  • Patient continues to follow up with spine surgeon for monitoring and follow-up care.
  • Patient continues to see improvements in symptoms over the course of 1-2 years post-surgery, with no major differences between those who had the combined procedure with fusion and those who had just the laminectomy.
  • Patient may experience slight differences in neck disability and pain between the two groups after 2 years, but these differences are small and may not be clinically significant.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal laminectomy include:

  1. What are the potential risks and complications associated with a spinal laminectomy procedure?
  2. How long is the recovery process after a spinal laminectomy?
  3. Will I need physical therapy or rehabilitation after the procedure?
  4. What are the expected outcomes and success rates of a spinal laminectomy for my specific condition?
  5. Are there any alternative treatment options to consider before undergoing a spinal laminectomy?
  6. How will a spinal laminectomy affect my daily activities and quality of life?
  7. Will I need any additional procedures or treatments in the future after a spinal laminectomy?
  8. How experienced are you in performing spinal laminectomy procedures, and what is your success rate with this surgery?
  9. What is the expected timeline for follow-up appointments and monitoring after a spinal laminectomy?
  10. Are there any specific lifestyle changes or precautions I should take after undergoing a spinal laminectomy?

Reference

Authors: Revesz DF, Charalampidis A, Gerdhem P. Journal: Eur Spine J. 2022 May;31(5):1300-1308. doi: 10.1007/s00586-022-07159-1. Epub 2022 Mar 14. PMID: 35288770