General Session: Cervical-2
Presented by: G-D. Chen - View Audio/Video Presentation (Members Only)
G-D. Chen(1), H-L. Yang(1), Z-P. Luo(1)
(1) Soochow University, Suzhou, China
Objective: To evaluate the efficacy of laminoplasty for the treatment of patients with occupying ratio greater than 50% and to determine possible factors related to surgical outcome of posterior decompression.
Background: Limited data is available about effect and prognostic factors of laminoplasty for cervical myelopathy with an occupying ratio greater than 50%.
Methods: Fifty-five consecutive patients with occupying ratio greater than 50% who underwent cervical laminoplasty between January 2005 and December 2010 were reviewed in this study. Patients with cervical kyphosis were excluded. Clinical and radiologic outcomes were assessed. Univariate analysis was used to investigate the relationship between recovery rate and the age, duration of symptoms, preoperative JOA score, posterior shift of the spinal cord, preoperative cervical lordosis, spinal cord compression ratio, and follow-up period. Multivariate linear regression analysis was used to determine the best surgical outcome predictor.
Results: All patients maintained cervical lordosis. Average JOA score improved from 10.7 ± 1.7 points preoperatively to 14.0 ± 1.4 points at the last follow up. The mean rate of recovery was 51.4±25.7%. Final recovery rates showed 6 excellent results, 29 good results, 18 fair results, and 2 poor results. Univariate analysis showed significant correlation between the recovery rate and the spinal cord compression ratio, duration of symptoms and posterior movement of the spinal cord. The multivariate linear regression analysis showed that the best surgical outcome predictor was the spinal cord compression ratio (0.698, P< 0.001). R-squared of the final multiple linear regression model was 0.509.
Conclusions: Laminoplasty can still be considered as decompressive pattern for patients with high occupying ratio greater than 50%. The spinal cord compression ratio, duration of symptoms and posterior movement of the spinal cord play important roles in recovery rate. The best surgical outcome predictor is the spinal cord compression ratio.