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Extraordinary positional cervical spinal cord compression in extension position as a rare cause of postoperative progressive myelopathy after cervical posterior laminoplasty detected using the extension/flexion positional CT myelography: one case after laminectomy following failure of a single-door laminoplasty/one case after double-door laminoplasty without interlaminar spacers.

作者信息

Fujiwara Yasushi, Manabe Hideki, Harada Takahiro, Izumi Bunichiro, Adachi Nobuo

机构信息

Department of Orthopaedic Surgery, Hiroshima City Asa Citizens Hospital, Kabe-minami 2-1-1, Asakita-ku, Hiroshima, 731-0293, Japan.

Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.

出版信息

Eur Spine J. 2017 May;26(Suppl 1):170-177. doi: 10.1007/s00586-017-5001-2. Epub 2017 Feb 28.


DOI:10.1007/s00586-017-5001-2
PMID:28247081
Abstract

PURPOSE: Posterior cervical laminectomies and laminoplasties are common treatments for cervical spondylotic myelopathy. However, recent studies demonstrated that positional spinal cord compression occurred after cervical laminectomies and caused postoperative progressive myelopathy. Although there were no such reports after laminoplasties, we report two cases in which symptomatic extraordinary positional spinal cord compression occurred after laminoplasties in this paper. METHODS: This study included two patients who showed progressive myelopathy: one case after a laminectomy following failure of a single-door laminoplasty and one case after a double-door laminoplasty without interlaminar spacers. RESULTS: The MRIs showed mild cord compression in the neutral position in both cases. However, the patients could not extend their necks, because it triggered severe neck pain and numbness. Therefore, the positional CT myelography (CTM) was taken in the flexion and extension positions, and it showed severe spinal cord compression only in the extension position. Posterior instrumented fusions were performed for both patients, which improved their symptoms. CONCLUSIONS: This paper demonstrates that postoperative positional spinal cord compression during neck extension caused a progressive myelopathy even after laminoplasty. When myelopathy symptoms worsen after laminoplasties, we recommend positional CTM/MRI evaluation, even though there is no apparent cord compression in the neutral MRI.

摘要

相似文献

[1]
Extraordinary positional cervical spinal cord compression in extension position as a rare cause of postoperative progressive myelopathy after cervical posterior laminoplasty detected using the extension/flexion positional CT myelography: one case after laminectomy following failure of a single-door laminoplasty/one case after double-door laminoplasty without interlaminar spacers.

Eur Spine J. 2017-5

[2]
Skip laminectomy and laminoplasty for cervical spondylotic myelopathy: a prospective study of clinical and radiologic outcomes.

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[3]
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[4]
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[5]
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[6]
In vivo 3D kinematic changes in the cervical spine after laminoplasty for cervical spondylotic myelopathy.

J Neurosurg Spine. 2014-9

[7]
Skip laminectomy--a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report.

Spine J. 2002

[8]
Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study.

Spine (Phila Pa 1976). 2007-8-15

[9]
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[10]
Cervical alignment and range of motion after laminoplasty: radiographical data from more than 500 cases with cervical spondylotic myelopathy and a review of the literature.

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引用本文的文献

[1]
Intraoperative and Postoperative Ultrasonographic Spinal Cord Evaluation of Cervical Double-Door Laminoplasty.

Cureus. 2024-5-29

[2]
Dynamic Cervical Cord Compression Post-laminectomy Visualized by Flexion-extension Magnetic Resonance Imaging: Case Report.

Cureus. 2019-1-14

[3]
Percutaneous ultrasonographic evaluation of the spinal cord after cervical laminoplasty: time-dependent changes.

Eur Spine J. 2018-9-7

[4]
Symptomatic cord compression by paraspinal musculature following cervical laminectomy: rare complication.

Eur Spine J. 2018-8

本文引用的文献

[1]
C2 spondylotic radiculopathy: the nerve root impingement mechanism investigated by para-sagittal CT/MRI, dynamic rotational CT, intraoperative microscopic findings, and treated by microscopic posterior foraminotomy.

Eur Spine J. 2017-4

[2]
Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI.

Case Rep Radiol. 2015

[3]
A new alarm point of transcranial electrical stimulation motor evoked potentials for intraoperative spinal cord monitoring: a prospective multicenter study from the Spinal Cord Monitoring Working Group of the Japanese Society for Spine Surgery and Related Research.

J Neurosurg Spine. 2013-11-15

[4]
Dynamic changes in spinal cord compression by cervical ossification of the posterior longitudinal ligament evaluated by kinematic computed tomography myelography.

Spine (Phila Pa 1976). 2014-1-15

[5]
Spinal cord cross-sectional area during flexion and extension in the patients with cervical ossification of posterior longitudinal ligament.

Eur Spine J. 2013-11

[6]
Impact of lamina closure on long-term outcomes of open-door laminoplasty in patients with cervical myelopathy: minimum 5-year follow-up study.

Spine (Phila Pa 1976). 2012-7-1

[7]
Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients.

Eur Spine J. 2010-2-27

[8]
Flexion myelopathy of the thoracic spine. Case report.

J Neurosurg Spine. 2007-1

[9]
Juvenile muscular atrophy of unilateral upper extremity.

Neurology. 1963-5

[10]
Local kyphosis reduces surgical outcomes of expansive open-door laminoplasty for cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2003-6-15

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