Our Summary

This research paper is basically a review of multiple studies to compare two types of surgical procedures, skip laminectomy and laminoplasty, for treating cervical compressive myelopathy, which is a condition where there’s pressure on the spinal cord in the neck area. The researchers looked at four different studies involving 241 patients. They found that both procedures were pretty much equal when it came to changes in the curve of the neck and the range of motion possible after surgery. However, they found that patients who had the skip laminectomy procedure reported significantly less pain and were less likely to experience axial pain, which is pain along the spine. Also, fewer patients who had the skip laminectomy procedure experienced significant muscle atrophy, or loss of muscle mass, compared to those who had the laminoplasty procedure. Therefore, the study concluded that skip laminectomy might be a better choice than laminoplasty for treating cervical compressive myelopathy. But, they also said that more research is needed to confirm these findings.

FAQs

  1. What are the two types of surgical procedures compared in this research paper for treating cervical compressive myelopathy?
  2. How did the outcomes of skip laminectomy and laminoplasty procedures compare in terms of post-surgery pain and muscle atrophy?
  3. Did the research conclusively determine which surgical procedure is better for treating cervical compressive myelopathy?

Doctor’s Tip

A doctor might tell a patient considering spinal laminectomy that it is important to follow post-operative instructions carefully, including participating in physical therapy and exercises to strengthen the muscles surrounding the spine. This can help improve overall outcomes and reduce the risk of complications. It is also important to maintain a healthy weight and lifestyle to support healing and prevent future issues with the spine.

Suitable For

Patients who are typically recommended spinal laminectomy are those who have cervical compressive myelopathy, which can cause symptoms such as neck pain, weakness in the arms and legs, numbness or tingling in the hands and feet, and difficulty walking. These patients may have tried non-surgical treatments such as physical therapy or medication without success, and their symptoms may be getting worse over time. Additionally, patients with spinal stenosis, herniated discs, or other conditions causing pressure on the spinal cord or nerves in the neck area may also be recommended for spinal laminectomy. Ultimately, the decision to undergo spinal laminectomy should be made in consultation with a healthcare provider based on the individual patient’s specific condition and needs.

Timeline

Before spinal laminectomy:

  1. Patient experiences symptoms of cervical compressive myelopathy, such as neck pain, weakness in the arms and legs, numbness or tingling in the extremities, and difficulty walking.
  2. Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis and determine the extent of the spinal cord compression.
  3. Patient consults with a spine surgeon to discuss treatment options, including the possibility of undergoing a spinal laminectomy procedure.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.

After spinal laminectomy:

  1. Patient is admitted to the hospital for the surgical procedure.
  2. During the procedure, the surgeon removes a portion of the lamina (bony arch) of the vertebra to relieve pressure on the spinal cord.
  3. After surgery, the patient may experience pain and discomfort at the surgical site, which is managed with pain medications.
  4. Physical therapy and rehabilitation are initiated to help the patient regain strength and mobility in the affected areas.
  5. Follow-up appointments are scheduled with the surgeon to monitor recovery and address any concerns or complications.
  6. Over time, the patient may experience improvements in symptoms, such as reduced pain, improved mobility, and increased function in the affected limbs.

What to Ask Your Doctor

  1. What is a spinal laminectomy and how does it differ from a laminoplasty?
  2. What are the potential risks and complications associated with a spinal laminectomy procedure?
  3. How long is the recovery time for a spinal laminectomy and what can I expect during the recovery process?
  4. Will I need physical therapy or rehabilitation after a spinal laminectomy procedure?
  5. How will a spinal laminectomy impact my daily activities and quality of life?
  6. Are there any alternative treatment options to consider besides a spinal laminectomy?
  7. What is the success rate of a spinal laminectomy for treating cervical compressive myelopathy?
  8. How many times have you performed spinal laminectomy procedures and what is your success rate?
  9. What is the difference in long-term outcomes between skip laminectomy and laminoplasty for treating cervical compressive myelopathy?
  10. Are there any specific post-operative care instructions I should follow after undergoing a spinal laminectomy procedure?

Reference

Authors: Luo W, Li Y, Zhao J, Zou Y, Gu R, Li H. Journal: World Neurosurg. 2018 Dec;120:296-301. doi: 10.1016/j.wneu.2018.08.231. Epub 2018 Sep 8. PMID: 30205220