Posterior spinal cord shift does not affect surgical outcomes after muscle-preserving selective laminectomy

Publication date: Available online 10 February 2018 Source:Journal of Clinical Neuroscience Author(s): Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda Postoperative posterior spinal cord shift (PSS) has been considered a required radiographic endpoint of posterior decompression procedures. To achieve PSS, laminoplasty for cervical compressive myelopathy (CCM) has been consecutively performed on four or more laminae (C2–C7, C3–C7, or C3–C6). However, the clinical significance of PSS remains controversial. By selecting the surgically treated laminae, selective laminectomy (SL) can achieve adequate decompression without disturbing the extensor musculature and facet joints. The clinical features and radiological findings from 162 patients with CCM whose decompression included C4/5 level were investigated. The postoperative C2–C7 angle, PSS at C4/5 level, and laminectomy width were measured. Radiologic factors affecting PSS and the relationship between PSS and functional outcome were analyzed. Smaller PSS was observed in cases involving two or fewer consecutive laminectomies than in cases involving three or more consecutive laminectomies. The number of consecutive laminae (CLs) surgically treated and the postoperative C2–C7 angle correlated with PSS. Multiple linear regression analyses showed that the number of surgically treated CLs was the greatest predictor of PSS. No correlation was observed between PSS...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research