A new article published in the Journal of Neurosurgery: Spine examines the trends and developments in cervical laminoplasty over the past 10 years.
The study authors conducted a Medline database search and examined articles focused on laminoplasty, laminectomy and posterior cervical spine procedures from 2003 to 2013. There were 103 studies included in the project. There were 130 patient groups including 8,949 patients.
The literature examined had three prospective, randomized studies on prospective nonrandomized alternating study; 15 prospective nonrandomized data collections; and 84 retrospective reviews.
The researchers found:
1. There is a trend of using miniplates or hydroxyapatite spacers on the open side in Hirabayashi-type laminoplasty or the open side in a Kurokawa-type laminoplasty, according to the study abstract.
2. The Japanese Orthopaedic Association scoring was the most commonly reported scoring type. There were 4,949 patients who reported JOA scores with improvement of 9.91 to a score of 13.56 on average after 44 months.
3. The average preoperative C2-7 angle was 14.17 degrees and remained stable to 13.98 degrees of lordosis postoperatively at the average 39 month follow-up. This information was available for 2,470 patients.
4. There was significantly decrease in kyphosis when muscle/posterior element-sparing techniques were used.
5. The hardware used in the form of hydroxyapatite spacers or miniplates didn't influence the deformity progression.
6. Around 47.3 percent of the patients reported lost range of motion.
7. The average postoperative pain level at 29 months follow-up on average was 2.78 on the visual analog scale. There were 1,249 patients involved in a study calculating the percentage of patients complaining about postoperative axial neck pain; 31 percent reported postoperative axial neck pain around 51 months after surgery.
8. There were 16 percent of the studies reporting C-5 palsy rate of more than 10 percent; another 41 percent of studies reported 5 percent to 10 percent C-5 palsy rate; and 23 percent of the studies reported a 1 percent to 5 percent. The remaining 12.5 percent did not report any cases of C-5 palsy.