These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Short Form-36 outcomes following focal 1- and 2-level cervical laminectomy with multilevel instrumented fusion.
    Author: Epstein NE, Epstein JA.
    Journal: Surg Neurol; 2006 Sep; 66(3):264-8; discussion 268. PubMed ID: 16935631.
    Abstract:
    BACKGROUND: Multilevel laminectomy with instrumented fusion addresses diffuse dorsal cord compression with an adequately preserved cervical lordosis. However, for patients with only 1 to 2 laminar impingement, more "focal" laminectomy and fusion may suffice, the shortened laminectomy allowing for a more simple spinous process fusion skipping the 1 or 2 lamina that have been removed. METHODS: Fourteen patients presented with severe spastic myeloradiculopathy (Nurick grade IV) attributed to magnetic resonance imaging- and CT-documented 1- to 2-level laminar compression, stenosis, and ossification of the yellow ligament. Magnetic resonance images also revealed 1- to 2-level hyperintense signals within the cord at the levels of maximal compromise. Surgical procedures included 1- to 2-level laminectomies and average 6.4-level posterior fusions. Dynamic x-ray/CT studies, which were obtained 3, 6, and up to 12 months postoperatively, followed progression toward fusion. Outcomes were assessed using Nurick grades (0-V) and SF-36 questionnaires assessed preoperatively and up to 12 months postoperatively. RESULTS: Patients improved on all 8 SF-36 Health Scales within the first postoperative year. Maximal improvement was observed on 5 Health Scales within the first 6 postoperative months (physical function, mental health, vitality, general health, role physical). The preoperative average Nurick grade (3.8) improved postoperatively (0.7 at 6 months, 0.5 at 1 year). Dynamic x-ray and CT studies documented fusion for all 14 patients by the sixth postoperative month. CONCLUSIONS: One- and two-level cervical laminectomies with multilevel-instrumented fusion effectively decompressed "focal" cord compression, whereas fusion maintained the cervical lordotic curvature and provided stability to avert future disease progression.
    [Abstract] [Full Text] [Related] [New Search]