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PubMed · 17097547

Cervical laminoplasty.

Abstract

Laminoplasty was developed to treat multilevel pathology of the cervical spine, namely ossification of the posterior longitudinal ligament and cervical spondylotic myelopathy. Laminoplasty was popularized in the 1980s, and since then many variations on the theme have been developed. All are similar in that they expand the cervical canal while leaving the protective dorsal elements in place. Advocates claim that this prevents the formation of the "postlaminectomy" membrane, maintains spinal alignment, and should aid in maintaining cervical range of motion. The aforementioned are all potential shortcomings of laminectomy or laminectomy and fusion. The procedure has proven to be essentially equal to other cervical decompressive procedures in the neutral or lordotic spine, and outcome has been shown to be durable.

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BibTeXRIS

Michael P Steinmetz, Daniel K Resnick. Cervical laminoplasty.. https://doi.org/10.1016/j.spinee.2006.04.023

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Surgical treatment of cervical kyphosis in Larsen syndrome: report of 3 cases and review of the literature.

STUDY DESIGN: A retrospective case series. OBJECTIVE: To review the surgical results for midcervical kyphosis in 3 cases with Larsen syndrome, and to discuss the choice of surgical treatments. SUMMARY OF BACKGROUND DATA: Cervical kyphosis is the most hazardous and serious manifestation of Larsen syndrome due to the risk of life-threatening paralysis, and thus usually requires surgical treatment. However, little information has been reported concerning surgical treatments for this challenging condition. METHODS: Three patients with Larsen syndrome were surgically treated for midcervical kyphosis at our institution. RESULTS: An infant with mild cervical kyphosis was successfully treated with posterior arthrodesis using a halo immobilization, and anterior vertebral growth with a mature posterior fusion mass resulted in spontaneous correction of the kyphosis. In the remaining 2 infants with myelopathic symptoms due to severe and structural kyphosis, anterior decompression and fusion via a lateral approach followed by posterior fusion with segmental spinal instrumentation and halo immobilization resulted in improved neurologic symptoms and solid fusion. CONCLUSIONS: Posterior spinal fusion is only indicated for patients with mild and flexible cervical kyphosis, and anterior decompression and circumferential arthrodesis is required for patients with severe kyphotic deformity, who usually develop myelopathic symptoms. Anterior surgery for such a small patient with severe kyphosis involves much higher risk of spinal cord injury during decompression maneuvers and difficulty in stabilization of the reconstructed cervical spine. Therefore, all patients with Larsen syndrome should be screened with radiographs at the first visit to detect cervical kyphosis early so that posterior alone fusion is possible.

Cervical Vertebrae↗