Our Summary

This research paper looked at two different types of surgery used to treat patients with a specific spine condition called multilevel cervical compressive myelopathy. The surgeries are known as laminoplasty and laminectomy followed by fusion. The researchers analyzed 23 studies involving 1,517 patients to see which surgery was more effective.

They looked at different outcomes such as scores on the Japanese Orthopaedic Association (JOA) test (a measure of how well the patient is doing), the curvature of the spine, pain levels, complications, blood loss, and how long the operation took.

The results showed no significant difference between the two surgeries in terms of the patient’s condition before and after surgery, the improvement in their condition, spine curvature, pain levels, complications, and blood loss.

However, they did find that the laminoplasty surgery took less time and had fewer instances of a specific complication known as C5 palsy (a type of paralysis affecting the arms and shoulders). So, while both surgeries were found to be broadly similar in effectiveness, laminoplasty was quicker and had fewer cases of C5 palsy.

FAQs

  1. What is multilevel cervical compressive myelopathy and what surgeries are used to treat it?
  2. What factors did the researchers consider when comparing the effectiveness of laminoplasty and laminectomy followed by fusion?
  3. Did the research find any significant differences between the two surgeries in terms of effectiveness and complications?

Doctor’s Tip

To reduce the risk of complications and improve recovery after a spinal laminectomy, it is important to follow your doctor’s post-operative instructions carefully. This may include engaging in physical therapy, avoiding heavy lifting, maintaining good posture, and taking prescribed medications as directed. Additionally, staying active and maintaining a healthy weight can help support a successful recovery. Be sure to communicate openly with your healthcare team about any concerns or changes in your condition.

Suitable For

Patients who are typically recommended for spinal laminectomy are those with symptoms of spinal stenosis, herniated discs, degenerative disc disease, or spinal tumors that are causing compression on the spinal cord or nerves. These patients may be experiencing symptoms such as numbness, weakness, pain, or difficulty walking. The decision to recommend spinal laminectomy will depend on the severity of the symptoms, the location of the compression, and the overall health of the patient.

Timeline

Before the surgery:

  1. Patient experiences symptoms of multilevel cervical compressive myelopathy such as neck pain, weakness in the arms and legs, 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.
  4. Patient undergoes pre-operative assessments and preparations for surgery.

During the surgery:

  1. Patient undergoes either laminoplasty or laminectomy followed by fusion surgery to decompress the spinal cord and stabilize the spine.
  2. The surgery typically takes several hours to complete.
  3. The patient is monitored closely by medical staff during and after the surgery.

After the surgery:

  1. Patient may experience some pain and discomfort at the surgical site.
  2. Patient is monitored for any post-operative complications such as infection or C5 palsy.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  4. Patient follows up with the surgeon for post-operative assessments and monitoring of their condition.
  5. Patient may experience improvement in their symptoms over time as they recover from the surgery.

Overall, the timeline for a patient undergoing spinal laminectomy includes pre-operative assessments, the surgery itself, and post-operative recovery and rehabilitation to improve their symptoms and quality of life.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about spinal laminectomy:

  1. What is the purpose of a spinal laminectomy and why is it recommended for my condition?
  2. Are there any alternative treatments to a spinal laminectomy that I could consider?
  3. What are the potential risks and complications associated with a spinal laminectomy?
  4. How long is the recovery process after a spinal laminectomy and what can I expect during this time?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How will my mobility and function be affected after a spinal laminectomy?
  7. What are the long-term outcomes and success rates of a spinal laminectomy for my specific condition?
  8. Are there any restrictions or limitations I should be aware of after the surgery?
  9. How often will I need follow-up appointments after the surgery?
  10. Are there any specific signs or symptoms I should watch for that may indicate a complication after the surgery?

Reference

Authors: Huang M, Gao X, Cheng J, Han J, Liu J. Journal: Medicine (Baltimore). 2016 Jun;95(23):e03588. doi: 10.1097/MD.0000000000003588. PMID: 27281067