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Segmental motor paralysis after cervical laminoplasty: a prospective study
Hironobu Sakaura1, Noboru Hosono, Yoshihiro Mukai
1Department of Orthopedics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. sakaurah@ort.med.osaka-u.ac.jp
Spine
|November 2, 2006
Summary
Segmental motor paralysis is more common after cervical laminoplasty, especially distal or diffuse types. Postoperative MRI showing linear intramedullary high-signal intensity areas (HIA) correlate with paralysis.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Previous cervical laminoplasty studies were retrospective.
- No prior studies investigated MRI in all subjects, including controls.
Purpose of the Study:
- Examine segmental motor paralysis prevalence and manifestations post-cervical laminoplasty.
- Investigate intramedullary high-signal intensity area (HIA) on postoperative MRI.
Main Methods:
- Prospective study of 79 patients undergoing cervical laminoplasty.
- Daily muscle strength evaluation for 3 weeks perioperatively.
- Pre- and postoperative MRI scans, with retrospective chart review of 79 controls.
Main Results:
- 10/79 prospective patients developed segmental motor paralysis (5 proximal, 2 distal, 3 diffuse).
- 4/79 control patients developed paralysis (3 proximal, 1 diffuse).
- Linear HIA on MRI correlated with paralyzed segments more than focal or no HIA.
Conclusions:
- Distal or diffuse paralysis occurred more frequently in prospective cervical laminoplasty cases.
- Linear intramedullary high-signal intensity areas were significantly associated with paralyzed segments.