Análise funcional e radiológica de 86 pacientes submetidos a nova técnica de laminoplastia cervical expansiva paramielopatia cervical espondilótica

Abstract

The surgical results of 86 patients who underwent a new technique of laminoplasty for the treatment of multilevel cervical spondylosis were analyzed prospectively. The goal was to describe the technique and evaluate its efficacy. The follow-up period was 3 years. There was 64 males (74%) and 22 females (26%) and their average age was 64,7 years. The pre and postoperative clinical evaluation was based on the Nurick scale. Radiologic evaluation included cervical X rays, computed tomography and magnetic resonance exams before and after surgery. Surgery was performed at C3-C7 in 80 patients (92%), at C2-C6 in 3 patients (4%) and at C2-T1 in 3 patients (3%). Foraminotomy was done in 23 patients ( 27%). The median of the clinical score decreased from 4 to 2 after surgery and was statistically significant (p<0,05). The mean duration of surgery was 122 minutes. An increase on the median of the canal sagittal diameter from 13 to 19 mm was observed after surgery and was statistically significant (p<0,05). There was statistically significant difference between the C2-C7 angle before and after surgery (p<0,05). There was no postoperative kyphosis or progressive cervical instability. One patient was reoperated because of local hematoma. One patient was reoperated after a clinical worsening which was caused by a laminar fracture and migration at one side of the laminoplasty. Two patients presented C5 radiculopaty which improved 6 months after surgery.