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. 2017 Jun;30(5):E609-E614.
doi: 10.1097/BSD.0000000000000233.

Regression of Anterior Disk-Osteophyte Complex Following Cervical Laminectomy and Fusion for Cervical Spondylotic Myelopathy

Adedayo O Ashana  1 , Jeremiah R Cohen, Brandon Evans, Langston T Holly
Affiliations

Regression of Anterior Disk-Osteophyte Complex Following Cervical Laminectomy and Fusion for Cervical Spondylotic Myelopathy

Adedayo O Ashana et al. Clin Spine Surg. 2017 Jun.

Abstract

Study design: A retrospective case-control study.

Objective: To investigate whether posterior cervical laminectomy and fusion modifies the natural course of anterior disk-osteophyte complex in patients with multilevel cervical spondylotic myelopathy.

Summary of background data: Dorsal migration of the spinal cord is the main purported mechanism of spinal cord decompression following cervical laminectomy and fusion but other potential mechanisms have received scant attention in the literature. This study was conducted to investigate whether cervical laminectomy and fusion affects the size of anterior disk-osteophyte complex.

Methods: The medical records and radiographic imaging of 44 patients who underwent cervical laminectomy and fusion for cervical spondylotic myelopathy between 2006 and 2013 were analyzed. The size of the anterior disk-osteophyte complex was measured preoperatively and postoperatively on MR images taken at an interval of >3 months apart. A control group consisted of 20 nonoperatively treated advanced cervical spondylosis patients. Patients in the control met the same inclusion and exclusion criteria and also had sequential magnetic resonance imaging (MRI) taken at an interval of >3 months apart.

Results: The nonoperative and operative groups were statistically similar in the pertinent patient demographics and characteristics including sex, age, time to second MRI, size of anterior disk-osteophyte complex on baseline MRI, mean number of levels affected, and percentage of patients with T2 signal change. As expected the mJOA scores were significantly lower in the operative versus nonoperative cohort (13.6 vs. 16.5, P<0.01). A significant decrease in the size of anterior disk osteophyte was observed in the operative group postoperatively (P<0.01). In comparison, there was no statistically significant change in the size of the anterior disk-osteophyte complex in the control group (P>0.05). The magnitude of the change in disk size between the 2 groups was statistically significant (P<0.01).

Conclusions: The findings of this study suggest that regression of anterior disk-osteophyte complex occurs following cervical laminectomy and fusion, and likely provides another mechanism of spinal cord decompression.

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Figures

Figure 1
Figure 1
(A(A) Preoperative T2 weighted sagittal MRI demonstrating severe spinal cord compression in an 80 year old gentleman with significant upper and lower extremity weakness as well as gait difficulty. (B) Postoperative MRI demonstrates regression of the anterior disc herniation and spinal cord decompression following laminectomy and fusion.)
Figure 1
Figure 1
(A(A) Preoperative T2 weighted sagittal MRI demonstrating severe spinal cord compression in an 80 year old gentleman with significant upper and lower extremity weakness as well as gait difficulty. (B) Postoperative MRI demonstrates regression of the anterior disc herniation and spinal cord decompression following laminectomy and fusion.)
Figure 2
Figure 2
(A) 68 year old woman with progressive gait difficulty and hand incoordination. MRI demonstrated significant C3-4 spinal cord compression. (B) She underwent C3-4 laminectomy and fusion and postoperative MRI demonstrated regression of the anterior disc herniation.
Figure 2
Figure 2
(A) 68 year old woman with progressive gait difficulty and hand incoordination. MRI demonstrated significant C3-4 spinal cord compression. (B) She underwent C3-4 laminectomy and fusion and postoperative MRI demonstrated regression of the anterior disc herniation.
Figure 3
Figure 3
51 year old gentleman with a history of neck pain and finger numbness, but denies any myleopathic symptoms. MRI revealed evidence of spinal canal stenosis from the anterior disc herniations. Due to his mild symptomatology the patient was treated nonoperatively.
Figure 4
Figure 4
Graph demonstrating that the size of the anterior disc osteophyte complex significantly decreased in size following cervical laminectomy and fusion. The size of the anterior disc osteophyte complex did not sequential imaging in the nonoperative group. significantly change in size on
See this image and copyright information in PMC

References

    1. Holly LT, Moftakhar P, Khoo L, et al. Surgical outcomes of elderly patients with cervical spondylotic myelopathy. Surgical Neurology. 2008;69:233–240. - PubMed
    1. Rao R. Neck pain, cervical radiculopathy, and cervical myelopathy: pathophysiology, natural history, and clinical evaluation. J Bone Joint Surg Am. 2002;84(10):1872–81. - PubMed
    1. Matz PG, Anderson PA, Holly LT, et al. The natural history of cervical spondylotic myelopathy. Journal of Neurosurgery Spine. 2009;11(2):104–111. - PubMed
    1. Mummaneni PV, Kaiser MG, Matz PG, et al. Cervical surgical techniques for the treatment of cervical spondylotic myelopathy. Journal of Neurosurgery Spine. 2009;11(2):130–141. - PubMed
    1. Saunders RL, Pikus HJ, Ball P, et al. Four-level cervical corpectomy. Spine (Phila Pa 1976) 1998;23(22):2455–2461. - PubMed

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