Our Summary

This research paper compares four different surgical methods for treating a neck condition called multilevel degenerative cervical myelopathy (MDCM). The four methods are open-door laminoplasty (OLP), French-door laminoplasty (FLP), laminectomy and fusion (LF), and laminectomy alone (LA).

The researchers analyzed 30 studies involving 2671 patients. They found no significant difference between the LF and OLP methods in terms of improving patients’ condition, as measured by the Japanese Orthopaedic Association score. However, both methods were found to be better than LA and FLP.

In terms of post-surgery flexibility (range of motion), LF was the worst compared to the other methods. Regarding complications from the procedures, the researchers found no significant differences.

When all factors were considered, none of the procedures stood out as the best in terms of both effectiveness and safety. Nonetheless, the researchers recommend OLP as it ranked second in terms of both improving patients’ condition and maintaining post-surgery flexibility, and had a fairly low rate of complications.

FAQs

  1. What are the four surgical methods compared in the research for treating multilevel degenerative cervical myelopathy?
  2. According to the research, which surgical method is recommended for treating MDCM and why?
  3. Were there any significant differences in post-surgery complications among the four surgical methods studied?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal laminectomy is to consider discussing the option of open-door laminoplasty (OLP) with their surgeon. Based on research comparing different surgical methods for treating spinal conditions, OLP was found to be effective in improving patients’ condition and maintaining post-surgery flexibility, with a relatively low rate of complications. It may be a good option to consider for patients undergoing spinal laminectomy.

Suitable For

Patients who are typically recommended spinal laminectomy are those suffering from conditions such as multilevel degenerative cervical myelopathy (MDCM), spinal stenosis, herniated discs, or spinal tumors. These patients may experience symptoms such as neck pain, numbness or weakness in the arms or legs, difficulty walking, or loss of bladder or bowel control. Spinal laminectomy is often recommended when non-surgical treatments have not been effective in relieving symptoms, and the patient’s condition is affecting their quality of life. It is important for patients to consult with their healthcare provider to determine if spinal laminectomy is the appropriate treatment option for their specific condition.

Timeline

Before spinal laminectomy:

  1. Patient experiences symptoms of multilevel degenerative cervical myelopathy (MDCM) such as neck pain, weakness, numbness, and difficulty walking.
  2. Patient undergoes diagnostic tests such as MRI or CT scans to confirm the diagnosis.
  3. Patient consults with a spine surgeon to discuss treatment options, including the possibility of spinal laminectomy.

After spinal laminectomy:

  1. Patient undergoes spinal laminectomy surgery to relieve pressure on the spinal cord and nerves.
  2. Patient may experience pain and discomfort immediately after surgery, which is managed with pain medication.
  3. Patient undergoes physical therapy to regain strength and mobility in the neck and upper body.
  4. Patient follows post-operative care instructions to ensure proper healing and reduce the risk of complications.
  5. Patient gradually resumes normal activities and experiences improvement in symptoms over time.

What to Ask Your Doctor

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

  1. What is the specific reason for recommending a spinal laminectomy in my case?
  2. What are the potential risks and complications associated with this procedure?
  3. How long is the recovery period after a spinal laminectomy?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. Are there any alternative treatments or procedures that could be considered instead of a laminectomy?
  6. What is the success rate of spinal laminectomy in treating my condition?
  7. How will my mobility and range of motion be affected after the surgery?
  8. What is the expected outcome in terms of pain relief and improvement in my condition?
  9. How long will the effects of the surgery last, and will I need further treatment in the future?
  10. Are there any specific lifestyle changes or precautions I should take after a spinal laminectomy?

Reference

Authors: Li X, Yu H, Welle K, Gathen M, Zhang L, Xiao J, Kabir K. Journal: Adv Ther. 2022 Jan;39(1):117-139. doi: 10.1007/s12325-021-01980-8. Epub 2021 Nov 23. PMID: 34812993