Follow-up after cervical laminectomy, with special reference to instability and deformity

Area of Science:

• Neurosurgery
• Orthopedics
• Spinal Surgery

Background:

• Cervical laminectomy is a surgical procedure to treat spondylotic myelopathy.
• Potential adverse effects include postoperative misalignment and instability.
• Long-term outcomes and risks require further investigation.

Purpose of the Study:

• To evaluate the long-term effects of cervical laminectomy on spinal stability and patient outcomes.
• To assess the incidence of subluxation, intervertebral movement, and spinal curvature post-surgery.
• To determine the correlation between radiographic findings and clinical outcomes.

Main Methods:

• Retrospective review of 46 patients undergoing cervical laminectomy for spondylotic myelopathy over a 4-year period.
• Radiographic assessment for static subluxation, intervertebral movement, and spinal curvature at an average follow-up of 7.7 years.
• Clinical outcome evaluation based on patient-reported results and functional assessment, particularly arm function.

Main Results:

• 26% of patients exhibited static subluxation (average slip 3.7 mm).
• 7% demonstrated abnormal intervertebral movement (1-2 mm).
• 74% showed abnormal spinal curvature on radiographs, with no observed correlation to outcome.
• 74% of patients reported good or fair outcomes; improved arm function was the primary objective benefit.

Conclusions:

• Cervical laminectomy can lead to spinal instability and postural anomalies.
• Despite potential instability, the procedure is considered justifiable for elderly patients with spondylotic myelopathy.
• Arm function improvement is a significant long-term benefit of the surgery.