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At least 217 records · Page 12Linked to original sources

PubMed1993

Spondylolysis and spondylolisthesis after five-level lumbosacral laminectomy for selective posterior rhizotomy in cerebral palsy.

Of 163 children who have undergone five-level lumbosacral laminectomies for selective posterior rhizotomy, 20% of those re-X-rayed post-operatively (19/99) have developed incidental isthmic spondylolysis or grade I spondylolisthesis. The majority of patients were ambulatory, active, spastic diplegics. There were five children with isthmic defects at L3-4, three at L4-5 and 11 at L5-S1. Six of the 19 children had grade I spondylolisthesis, but none were symptomatic nor has there been any evidence of further slipping to date. It is postulated that the laminectomy, associated lordosis and increased mobility after rhizotomy may be factors in the causation.

Adolescent↗

PubMed1989

Cervical spinal deformity following craniotomy and upper cervical laminectomy for posterior fossa tumors in children.

Spinal deformity is not usually regarded as a potential complication of posterior fossa tumor resection. After cervical subluxation had been recognized in 2 children following removal of posterior fossa tumors, a review was carried out to determine the incidence of this complication. Of the 72 children who had undergone resection of a posterior fossa tumor, 4 patients, including the original 2, developed a cervical spinal deformity. Factors that predisposed to this complication included laminectomy of C2 or lower, local wound complications and possibly post-operative neck weakness. It is important to be aware that cervical subluxation can occur after resection of posterior fossa tumors, when laminectomy extending below C1 has been performed. Patients at risk should be followed closely.

Brain Neoplasms↗

PubMed1979

The results of surgical treatment of spondylotic radiculomyelopathy with complete cervical laminectomy and posterior foramen magnum decompression.

Twenty-six patients with cervical spondylosis and radiculomyelopathy were treated surgically. Eight patients had cervical laminectomy C1--C7, and 16 patients had complete cervical laminectomy C1--C7 with excision of the posterior rim of the foramen magnum. Follow-up of patients was from two months to eight years. The majority of patients improved markedly, and some of them had excellent results.

Adult↗

PubMed1982

A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years.

This paper reviews management by means of the posterior approach of 50 patients with cervical myeloradiculopathy caused by spondylosis and stenosis of the spinal canal seen in the past 10 years. Careful selection of patients is an absolute necessity since a primary cause of failure occurred in individuals who subsequently proved to have motor neurone disease. Older individuals with long-standing neurological deficits, especially long tract signs indicative of fixed lesions, were benefited primarily by a lack of further progression of their disorder and occasional improvement in hand function and gait. Diagnostic evaluation should include electromyography, nerve conduction studies, and sensory evoked cortical potentials. With the introduction of the fourth generation CAT scanning equipment, additional diagnostic information is available regarding the internal configuration of the spinal canal, its contents, and the amount of available space at various levels. Supplementary myelography remains of basic importance. Laminectomy includes two levels above and below the areas of significant canal encroachment. Foraminal decompression with removal of only the innermost third of the foramen permits mobilization of the nerve roots, removal of osteophytes and untethering of the dural sac. A great deal of importance is attached to the preservation of the cervical lordotic curve since, with an adequate decompression and an intact dura, the cord moves dorsally into an expanded canal, rising above the ventrally situated osteophytes. In those patients with reversal of the cervical curve and swan neck deformities, posterior decompression has not been of value. Recent more radical procedures in such cases, such as vertebrectomy, remain to be evaluated. Any procedure which will permit further kyphotic deformity, such as laminectomy, is contraindicated. Eighty-five percent of the patients operated upon by the recommended surgical approach improved.

Adult↗

PubMed1976

Influence of laminectomy on the course of cervical myelopathy.

The pathogenesis of cervical myelopathy resulting from cervical spondylarthrosis seems to be the result of intermittent compression of the cervical cord and its feeding arteries. In the literature proof is given that both factors play an important role. By laminectomy or ventral fusion a regression of the neurological disability can be obtained. In our series of 75 patients there was no significant difference in the results obtained by either partial or total laminectomy. In all our cases there was a narrowing of the sagittal spinal diameter.

Cervical Vertebrae↗

PubMed2006

Identification of the lumbar intervertebral level using ultrasound imaging in a post-laminectomy patient.

A spinal block was performed in a post-laminectomy patient, using both ultrasound imaging and X-ray imaging. Ultrasound imaging clearly identified the L3/4 intervertebral level, the spinal canal, the corpus vertebrae, and the dura mater. Using ultrasound imaging, we measured the distance from the skin surface to the dura mater (39 mm). A 25-G needle for the spinal block was accurately advanced into the spinal canal with the use of X-ray imaging (43 mm from the skin to the subarachnoid space). We report here that ultrasound imaging was useful for performing a spinal block in a post-laminectomy patient in whom there was anatomical change around the spine.

Aged, 80 and over↗

PubMed2003

Experimental study of osteoplastic laminectomy in the lumbar spine of rabbits.

Osteoplastic laminectomy has been used to treat lumbar canal stenosis and to prevent postoperative lumbar spinal instability by reconstructing the posterior element of the lumbar spine, which has been documented in many clinical studies. However, the biological sequence of repairing the posterior lumbar element, which is replaced at the time of surgery, has not yet been made clear. An in vivo rabbit study was designed to observe the biological sequence of repairing the replaced posterior element of the lumbar spine. Twenty-one adult rabbits underwent osteoplastic laminectomy at the L6. Animals were killed at 2, 4, 8, 12, 26, and 52 weeks after surgery. The samples of the L6 vertebra, which contained the replaced lamina and spinous process, were analyzed by radiography, computed tomography (CT), and a histological method. Overall, radiograms demonstrated clearly the union of interarticular osteotomized sites from 4 to 8 weeks. CT findings revealed that the union of interarticular osteotomized sites could be confirmed beginning at 12 weeks, and that postoperative narrowing of the lumbar spinal canal had not occurred in the rabbit model. The biological sequence of repairing the replaced lamina and spinous process was characterized by slowly progressive creeping substitution, with continuous remodeling.

Animals↗

PubMed1999

Degenerative lumbar spinal stenosis. Long-term results after undercutting decompression compared with decompressive laminectomy alone or with instrumented fusion.

The aim of the study was to evaluate the long-term outcome of various surgical procedures for lumbar spinal stenosis. Operations were performed on 117 consecutive patients for lumbar spinal stenosis between 1987 and 1992. Pre- and intraoperative data were recorded in a standardized manner. Three treatment groups were distinguished: group I consisting of 39 patients submitted to undercutting decompression; group II, 51 patients, submitted to laminectomy and foraminal decompression alone; and group III, 27 patients, who underwent foraminal decompression and laminectomy with instrumented fusion. Eight years (5-10 years) after surgery a questionnaire was mailed to the patients containing the outcome scales according to Greenough and Fraser [6] and Turner et al. [22] together with questions about residual pain, necessity of treatment and satisfaction with the operative outcome. A total of 72 questionnaires (61.6%) gave enough information for analysis. After a mean follow-up of 8 years, walking capacity had increased significantly in all groups (P < 0.001). Compared to preoperative values, pain had decreased significantly in all groups (P < 0.01). In group I 36% had good-to-excellent outcomes, and 30.8% and 23.8% in groups II and III (P > 0.05). Forty percent of group I patients were unsatisfied with the result, compared to 38.4% and 33.3% in the other groups (P > 0.05). Overall, 25 of 72 patients (34.7%) had severe constant back and/or leg pain requiring daily administration of analgesics. We conclude that the long-term outcome of decompressive surgery of the lumbar spinal canal, without and with instrumented fusion, is less favourable than was previously reported.

Aged↗

PubMed2004

Post-laminectomy long-term survival of a patient with spinal cord compression secondary to metastatic prostate cancer.

Spinal cord compression is a skeletal-related event in advanced malignancies and is associated with serious morbidity and poor prognosis. Despite the palliative nature of laminectomy treatment, it is important to prevent neurological deficits and relieve pain as a means to improve quality of life. Here we report on a prostate cancer patient with spinal cord compression who became ambulant from paraparesis after he underwent a decompression laminectomy; he survived for 9.5 years with good quality of life.

Decompression, Surgical↗

PubMed1976

Neurogenic bladder dysfunction in protruded lumbar disk and after laminectomy.

Bladder and urethral innervation was studied in 18 patients with protruded lumbar disk or persistent back pain after laminectomy. A high incidence of neurogenic dysfunction of the detrusor muscle was found, whereas impaired function of the striated external urethral sphincter was rare. The lesions were encountered among the patients with protruded lumbar disk as well as among the patients with sequelae after laminectomy, suggesting that neurogenic bladder dysfunction in cauda equina injury due to protruded disk is often irreversible.

Adult↗

PubMed1981

Electrocardiographic changes after cervical laminectomy.

Striking T-wave inversions were observed in the postoperative electrocardiograms of a 64-year-old woman following an extensive cervical laminectomy. Except for the presence of a trace amount of CK-MB in a single serum specimen all her enzyme and isoenzyme studies were negative, and her clinical course was not suggestive of myocardial ischemia. Coronary angiography, including an ergonovine study, done 6 mth following the laminectomy were normal. Because of the nature of this patient's neurogenic origin of these T-wave changes is suspected.

Cervical Vertebrae↗

PubMedDate not supplied

Epidural opioids during laminectomy surgery for postoperative pain.

STUDY OBJECTIVE: To determine whether morphine applied directly to the dura during laminectomy surgery provides superior postoperative analgesia during the first 24 hours. DESIGN: Randomized, double-blind study. SETTING: A university-affiliated hospital. PATIENTS: Twenty ASA physical status I and II patients ages 18 to 60 years. INTERVENTIONS: Simultaneous topical dural application and intramuscular (IM) injection of unknown solutions of saline and morphine 3 mg. MEASUREMENTS AND MAIN RESULTS: Postoperative analgesia was assessed using the visual analog scale (VAS), a modified McGill-Melzack pain questionnaire, subjective nursing evaluations, and the amount of supplemental analgesic medication used. Patients were observed for complications and side effects. Compared with the patients who received epidural saline and IM morphine, the patients who received epidural morphine and IM saline had less postoperative pain as determined by VAS scores, nursing evaluations, and amount of supplemental opioid analgesic doses (1.6 +/- 1.2 vs. 4.1 +/- 1.2 analgesic doses per patient; p less than 0.05) required in the first 24 hours. Minor side effects were similar for the two groups. No patient developed respiratory depression. CONCLUSIONS: Morphine 3 mg applied topically to the dura at the end of laminectomy surgery is a simple, safe, and effective way of providing improved postoperative analgesia.

Adolescent↗

PubMed1995

Analysis of early failures after lumbar decompressive laminectomy for spinal stenosis.

OBJECTIVE: To determine why some patients have no improvement after surgical treatment of lumbar spinal stenosis. DESIGN: We conducted a retrospective study of patients who were referred to our institution between 1990 and 1993 because their symptoms were unchanged or worsened after lumbar decompressive laminectomy. MATERIAL AND METHODS: For the 45 study patients (25 women and 20 men; mean age, 70.8 years), preoperative and postoperative clinical status, preoperative and postoperative imaging studies, and operative reports were analyzed. RESULTS: Preoperatively, only 23 patients (51%) had the clinical syndrome of neurogenic claudication, and 15 (33%) had midline low-back pain without a radicular component. Three other patients had peripheral neuropathy, and three had atypical leg pain. Only 10 patients had radiographic evidence of severe lumbar canal stenosis; the others had moderate, mild, or no stenosis. In 10 patients, surgical decompression was inadequate. Only three patients had the triad of neurogenic claudication, radiographically confirmed severe lumbar stenosis, and adequate decompression of the lumbar canal and lateral recesses. CONCLUSION: The most common pattern in patients with early failure after lumbar laminectomy was the absence of actual neurogenic claudication coupled with the absence of severe stenosis on preoperative imaging studies. The most common technical error was inadequate neural decompression. These data suggest that the outcome may be improved by more careful selection of patients and by performance of an adequate surgical decompression.

Aged↗

PubMed2000

Posterior interbody fusion using laminectomy bone and transpedicular screw fixation in the treatment of lumbar spondylolisthesis.

BACKGROUND: Laminectomy bone is used widely in posterolateral lumbar fusion, but not interbody fusion. No prospective evaluation of interbody fusion using bone grafts from the posterior neural arch in spondylolisthesis has been found in the literature. We prospectively studied series of patients operated on for lumbar spondylolisthesis to evaluate clinical improvement and bony fusion. METHODS: Forty-six patients were operated on for lumbar spondylolisthesis using a simplified one-stage posterior procedure. The whole mobile dorsal segment of the vertebral arch was taken out in one piece and the bone was used for interbody fusion. Fixation was performed with transpedicular screws and rods using transverse connectors. RESULTS: After an average follow-up time of 27.3 months, 87% of the patients could be considered to have an excellent or good clinical outcome. The rate of successful fusion was 95.7%. No noteworthy complications occurred. CONCLUSION: Laminectomy bone seems to be optimal for posterior interbody fusion and together with transpedicular rigid fixation the long-term clinical and radiological results are convincingly good. The method is advisable even for severe spondylolisthesis.

Adolescent↗

PubMed2000

The barrier effect of laminae: laminotomy versus laminectomy.

STUDY DESIGN: An experimental study to investigate whether replacement of the laminae (laminotomy) after subliminal procedures can prevent the invasion of scar tissue towards the dura. SETTING: Izmir, Turkey. METHODS: Laminectomy and laminotomy were performed at different levels on seven rats. Their spinal columns were investigated histopathologically after a period of 3 months. RESULTS: The histopathological evaluation revealed that the dura and spinal cord were involved by scar tissue at laminectomy area. However, this invasion was not observed at laminotomy levels. This study showed the barrier effect of laminae against fibroblastic activity. CONCLUSION: The barrier effect of lamina may affect the surgical outcome related to epidural fibrosis.

Animals↗

PubMedDate not supplied

[Occurrence of a segmental kyphosis after laminectomy of C2 for an aneurysmatic bone cysts--course and treatment strategy].

HISTORY: A 9-year-old girl suffered from an enlarging tumor in the lamina of the axis. After resection of the aneurysmatic bone cyst via laminectomy of C2 an anterior plate-fusion of C2/3 was done. Instead of a correctly placed ventral cervical plate, an adjacent instability of the level C3/4 with kyphosis and subluxation of the facet joints was seen at follow-up. COURSE OF TREATMENT: After reposition over a hypomochlion retention was achieved with a halo body-jacket. Two weeks later the level C3/4 was stabilized by posterior instrumentation. After almost two years the patient has no complaints and the radiological controls show correctly placed instrumentation and increasing bony fusion at the levels C2/3 and C3/4. CONCLUSION: Especially in children and adolescents laminectomy of a cervical vertebra often leads to kyphotic deformities. When using a posterior approach for surgery of intraspinal lesions or in case of tumors of the dorsal elements of the spine, the laminae and posterior structures should be preserved or, respectively, reconstructed for restoration of traction and tension mechanisms. This is of essential relevance for biomechanical stability and maintenance of the sagittal profile of the spine.

Bone Cysts, Aneurysmal↗

PubMed1981

[Cervical osteoplastic laminectomy for an intramedullary astrocytoma in an eight-year-old child (author's transl)].

In view of the hazards of extensive laminectomy in children, an osteoplastic laminectomy was used in an eight-year-old child suffering from an intramedullary astrocytoma extending from C4 to C7. The laminae were first of all divided bilaterally about 2 mm medial to their origin, with a fine spherical cutter. After dividing the ligamenta flava and the interspinous ligaments the dorsal wall of the spinal canal from C4 to C7 was removed en bloc. The dura was opened and the spinal cord split in the midline after which the microsurgical excision of a spindle-shaped cystic astrocytoma was carried out. After closing the dura drill holes were made bilaterally in the stumps of the pedicles and in the ends of the resected laminae. The entire piece, consisting of laminae and ligaments was replaced and fixed to the stumps of the pedicles with four pairs of wire sutures. Included in the sutures was a small block of bone measuring 2 x 3 x 5 mm, which replaced the bone lost in the saw-cuts and thus prevented any narrowing of the spinal canal. The ligaments were sutured and the wound closed in layers, with drainage. Immobilization in a Minerva plaster for three months.

Astrocytoma↗

PubMed1991

[A iatrogenic arteriovenous fistula following laminectomy. A rare differential diagnosis of heart failure].

An abdominal murmur was first heard in a now 46-year-old man four years after laminectomy at the age of 21. Signs of right heart failure and, ultimately, of global heart failure developed progressively and increasingly 20 years later. Echocardiography demonstrated enlargement of the right heart cavities, and atrial fibrillation was diagnosed. Cardiac catheterization revealed the typical picture of high output failure (cardiac output 13.9 l/min). Intra-arterial subtraction angiography demonstrated a fistula between the left iliac artery and vein. After operative closure of the fistula the signs of heart failure disappeared. Six months later a residual but insignificant fistula was still present, as well as persistent atrial fibrillation. Medical treatment having failed cardioversion successfully re-established sinus rhythm and the patient became symptom-free. Arteriovenous fistula after laminectomy is a rare cause of heart failure and often diagnosed very late. The prognosis is good once the fistula has been closed.

Arteriovenous Fistula↗