Minimum invasive posterior decompression for cervical spondylotic amyotrophy.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Procedures

Background:

• Cervical spondylotic amyotrophy (CSA) causes upper limb weakness due to spinal cord or nerve root damage.
• Traditional anterior decompression and fusion have limitations; posterior decompression is emerging as an effective alternative.
• A consensus on the optimal surgical approach for CSA remains elusive.

Purpose of the Study:

• To evaluate the efficacy of selective laminoplasty combined with foraminotomy for treating CSA.
• To assess the impact of this minimally invasive posterior decompression on muscle strength and neck pain.

Main Methods:

• A cohort of 28 CSA patients (average age 50.6 years) underwent selective laminoplasty with foraminotomy.
• Surgical outcomes were assessed by muscle strength (Manual Muscle Testing - MMT), cervical range of motion (ROM), and postoperative neck pain (Visual Analog Scale - VAS).
• Follow-up averaged 43.5 months, evaluating deltoid, biceps, and hand muscle involvement.

Main Results:

• Muscle strength improved significantly: 18 patients rated "excellent", 9 "good", and 1 "fair".
• Cervical range of motion was well-maintained, averaging 91.2% of pre-operative levels.
• Postoperative neck pain significantly decreased, with VAS scores dropping from 2.6 (day 1) to 1.2 (1 week).

Conclusions:

• Selective laminoplasty with segmental decompression offers a minimally invasive option for CSA treatment.
• The procedure effectively decompressess the spinal cord and nerve roots, leading to improved muscle strength.
• This approach minimizes postoperative neck pain while preserving cervical mobility.