• World Neurosurg · Dec 2023

    Optimal treatment of C3 lamina in Cervical laminoplasty.

    • Hidenori Matsuoka, So Ohashi, Michihisa Narikiyo, Ryo Nogami, Keita Hashimoto, Minami Wade, Hirokazu Nagasaki, and Yoshifumi Tsuboi.
    • Department of Neurosurgery, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan. Electronic address: matsuoka119@yahoo.co.jp.
    • World Neurosurg. 2023 Dec 1; 180: e618e623e618-e623.

    Study DesignResults of C4-C6 laminoplasty with C3 laminectomy and C3-C6 laminoplasty were compared retrospectively.ObjectivesTo clarify the difference between C3 laminectomy and C3 laminoplasty in cervical laminoplasty.Summary Of Background DataIntraoperative damage to the semispinalis cervicis has been shown to lead to postoperative axial symptoms and reduced range of motion (ROM). To prevent this event, C3 laminectomy in cervical laminoplasty is considered superior to C3 laminoplasty.MethodsA total of 36 patients were included in this study: 20 patients (GroupA) of C3 laminectomy, C4-C6 laminoplasty compared with 16 patients (GroupB) of C3-C6 laminoplasty. We collected patient's background data, operative time, Japanese Orthopaedic Association (JOA) score, VAS score, and radiologic findings such as C2-C7 Cobb angle, ROM, C2 inter-spinous angle, and use of postoperative PRN medication were compared.ResultsThere was no statistically significant difference in the C2-C7 Cobb angles between the 2 groups before and after surgery (P = 0.315). In ROM, there was a 17.7% decrease from 31.5 preoperatively to 25.9 postoperatively in Group A, and a 6.1% decrease from 29.3 preoperatively to 27.5 postoperatively in Group B. There was no statistically significant difference in ROM (P = 0.683). Postoperative neck pain (VAS) was significantly lower in Group A than in Group B both at 1 week (P = 0.015) and 1 month (P = 0.035) after surgery. The C2 inter-spinous angle was statistically significantly smaller in Group A than in Group B (P = 0.004). Clinical outcomes and surgical outcomes did not differ significantly between groups.ConclusionsIf the C2 interspinous angle is wide and intraoperative semispinalis capitis damage can be minimized, it is worth trying C3 laminoplasty, but if the C2 inter-spinous angle is narrow, C3 laminectomy is recommended from the beginning.Copyright © 2023 Elsevier Inc. All rights reserved.

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