Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy

Ahmed Nagaty; Ahmad Elsabaa; Mohamed Helmy Abd Elshafouk

doi:doi:10.11648/j.ijn.20220602.18

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Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy

Ahmed Nagaty, Ahmad Elsabaa, Mohamed Helmy Abd Elshafouk

Published in International Journal of Neurosurgery (Volume 6, Issue 2)

Received: 7 September 2022 Accepted: 26 September 2022 Published: 11 October 2022

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Abstract

This study aims to assess the efficacy and accuracy of a technique for posterior cervical decompression and fixation using high speed drill for posterior laminectomy and anatomical lateral mass screws placement. Background: Posterior cervical decompression through laminectomy is a well-known approach for surgical management of multiple levels cervical spondylosis with myelopathy, and ossification of the posterior longitudinal ligament (OPLL). Posterior decompression with lateral mass fixation helps to improve the clinical symptoms of those patients, in addition to improvement of their cervical curvature and range of motion. Methods: This is a retrospective study conducted from February 2019 to January 2021 included 30 patients with cervical myelopathy that underwent multiple levels posterior cervical laminectomy and lateral mass fixation using high speed drill. The primary outcomes measured in our study were Visual Analog Score (VAS) of neck pain and upper limbs pain, Japanese Orthopedic Association (JOA) score for assessment of cervical myelopathy for all those patients with comparison of preoperative and postoperative values up to 12 months after surgery. Secondary parameters assessed were perioperative complications, duration of surgical procedures, operative blood loss and hospital stay. Results: The included 30 patients in our study were 18 males (60%) and 12 females (40%), with mean age of 65.77 ± 5.056 years. Laminectomy and anatomical lateral mass screws placement using high speed drill approach showed average operative time of 119.83 ± 13.676 minutes, and minimal blood loss with mean 95.83 ± 14.389 ml. As regards VAS, our results showed marked improvement of postoperative VAS of neck pain 2.53 ± 0.73 and postoperative VAS of upper limbs 1.73 ± 0.828 at 12 months follow up in comparison to preoperative VAS values of neck pain 6.17 ± 1.51 and upper limbs 9.03 ± 0.85 with highly significant statistical difference value (P  0.001). In addition, there was significant improvement of Postoperative JOA score 15.06 ± 1.36 in comparison to preoperative values 9.56 ± 1.43, also with highly significant statistical difference (P  0.001). Conclusion: Posterior cervical decompression and fixation using high speed drill for Laminectomy and Anatomical lateral mass screws placement is an effective method for management of cases of cervical myelopathy with Favorable outcomes observed at 12 month follow up, with optimum operative time and minimal blood loss. However, a multicenter comparative study with long term follow-up is highly recommended.

Published in	International Journal of Neurosurgery (Volume 6, Issue 2)
DOI	10.11648/j.ijn.20220602.18
Page(s)	77-83
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Cervical Myelopathy, Lateral Mass Fixation, Cervical Laminectomy, High Speed Drill

References

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APA Style

Ahmed Nagaty, Ahmad Elsabaa, Mohamed Helmy Abd Elshafouk. (2022). Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. International Journal of Neurosurgery, 6(2), 77-83. https://doi.org/10.11648/j.ijn.20220602.18

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ACS Style

Ahmed Nagaty; Ahmad Elsabaa; Mohamed Helmy Abd Elshafouk. Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. Int. J. Neurosurg. 2022, 6(2), 77-83. doi: 10.11648/j.ijn.20220602.18

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AMA Style

Ahmed Nagaty, Ahmad Elsabaa, Mohamed Helmy Abd Elshafouk. Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. Int J Neurosurg. 2022;6(2):77-83. doi: 10.11648/j.ijn.20220602.18

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@article{10.11648/j.ijn.20220602.18,
  author = {Ahmed Nagaty and Ahmad Elsabaa and Mohamed Helmy Abd Elshafouk},
  title = {Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {77-83},
  doi = {10.11648/j.ijn.20220602.18},
  url = {https://doi.org/10.11648/j.ijn.20220602.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.18},
  abstract = {This study aims to assess the efficacy and accuracy of a technique for posterior cervical decompression and fixation using high speed drill for posterior laminectomy and anatomical lateral mass screws placement. Background: Posterior cervical decompression through laminectomy is a well-known approach for surgical management of multiple levels cervical spondylosis with myelopathy, and ossification of the posterior longitudinal ligament (OPLL). Posterior decompression with lateral mass fixation helps to improve the clinical symptoms of those patients, in addition to improvement of their cervical curvature and range of motion. Methods: This is a retrospective study conducted from February 2019 to January 2021 included 30 patients with cervical myelopathy that underwent multiple levels posterior cervical laminectomy and lateral mass fixation using high speed drill. The primary outcomes measured in our study were Visual Analog Score (VAS) of neck pain and upper limbs pain, Japanese Orthopedic Association (JOA) score for assessment of cervical myelopathy for all those patients with comparison of preoperative and postoperative values up to 12 months after surgery. Secondary parameters assessed were perioperative complications, duration of surgical procedures, operative blood loss and hospital stay. Results: The included 30 patients in our study were 18 males (60%) and 12 females (40%), with mean age of 65.77 ± 5.056 years. Laminectomy and anatomical lateral mass screws placement using high speed drill approach showed average operative time of 119.83 ± 13.676 minutes, and minimal blood loss with mean 95.83 ± 14.389 ml. As regards VAS, our results showed marked improvement of postoperative VAS of neck pain 2.53 ± 0.73 and postoperative VAS of upper limbs 1.73 ± 0.828 at 12 months follow up in comparison to preoperative VAS values of neck pain 6.17 ± 1.51 and upper limbs 9.03 ± 0.85 with highly significant statistical difference value (P  0.001). In addition, there was significant improvement of Postoperative JOA score 15.06 ± 1.36 in comparison to preoperative values 9.56 ± 1.43, also with highly significant statistical difference (P  0.001). Conclusion: Posterior cervical decompression and fixation using high speed drill for Laminectomy and Anatomical lateral mass screws placement is an effective method for management of cases of cervical myelopathy with Favorable outcomes observed at 12 month follow up, with optimum operative time and minimal blood loss. However, a multicenter comparative study with long term follow-up is highly recommended.},
 year = {2022}
}

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TY  - JOUR
T1  - Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy
AU  - Ahmed Nagaty
AU  - Ahmad Elsabaa
AU  - Mohamed Helmy Abd Elshafouk
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.18
DO  - 10.11648/j.ijn.20220602.18
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 77
EP  - 83
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.18
AB  - This study aims to assess the efficacy and accuracy of a technique for posterior cervical decompression and fixation using high speed drill for posterior laminectomy and anatomical lateral mass screws placement. Background: Posterior cervical decompression through laminectomy is a well-known approach for surgical management of multiple levels cervical spondylosis with myelopathy, and ossification of the posterior longitudinal ligament (OPLL). Posterior decompression with lateral mass fixation helps to improve the clinical symptoms of those patients, in addition to improvement of their cervical curvature and range of motion. Methods: This is a retrospective study conducted from February 2019 to January 2021 included 30 patients with cervical myelopathy that underwent multiple levels posterior cervical laminectomy and lateral mass fixation using high speed drill. The primary outcomes measured in our study were Visual Analog Score (VAS) of neck pain and upper limbs pain, Japanese Orthopedic Association (JOA) score for assessment of cervical myelopathy for all those patients with comparison of preoperative and postoperative values up to 12 months after surgery. Secondary parameters assessed were perioperative complications, duration of surgical procedures, operative blood loss and hospital stay. Results: The included 30 patients in our study were 18 males (60%) and 12 females (40%), with mean age of 65.77 ± 5.056 years. Laminectomy and anatomical lateral mass screws placement using high speed drill approach showed average operative time of 119.83 ± 13.676 minutes, and minimal blood loss with mean 95.83 ± 14.389 ml. As regards VAS, our results showed marked improvement of postoperative VAS of neck pain 2.53 ± 0.73 and postoperative VAS of upper limbs 1.73 ± 0.828 at 12 months follow up in comparison to preoperative VAS values of neck pain 6.17 ± 1.51 and upper limbs 9.03 ± 0.85 with highly significant statistical difference value (P  0.001). In addition, there was significant improvement of Postoperative JOA score 15.06 ± 1.36 in comparison to preoperative values 9.56 ± 1.43, also with highly significant statistical difference (P  0.001). Conclusion: Posterior cervical decompression and fixation using high speed drill for Laminectomy and Anatomical lateral mass screws placement is an effective method for management of cases of cervical myelopathy with Favorable outcomes observed at 12 month follow up, with optimum operative time and minimal blood loss. However, a multicenter comparative study with long term follow-up is highly recommended.
VL  - 6
IS  - 2
ER  -

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Author Information

Ahmed Nagaty

Department of Neurosurgery, Ain Shams University, Cairo, Egypt
Ahmad Elsabaa

Department of Neurosurgery, Ain Shams University, Cairo, Egypt
Mohamed Helmy Abd Elshafouk

Department of Neurosurgery, Ain Shams University, Cairo, Egypt

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Plain Text BibTeX RIS

APA Style

Ahmed Nagaty, Ahmad Elsabaa, Mohamed Helmy Abd Elshafouk. (2022). Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. International Journal of Neurosurgery, 6(2), 77-83. https://doi.org/10.11648/j.ijn.20220602.18

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ACS Style

Ahmed Nagaty; Ahmad Elsabaa; Mohamed Helmy Abd Elshafouk. Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. Int. J. Neurosurg. 2022, 6(2), 77-83. doi: 10.11648/j.ijn.20220602.18

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AMA Style

Ahmed Nagaty, Ahmad Elsabaa, Mohamed Helmy Abd Elshafouk. Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy. Int J Neurosurg. 2022;6(2):77-83. doi: 10.11648/j.ijn.20220602.18

Copy | Download

@article{10.11648/j.ijn.20220602.18,
  author = {Ahmed Nagaty and Ahmad Elsabaa and Mohamed Helmy Abd Elshafouk},
  title = {Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy},
  journal = {International Journal of Neurosurgery},
  volume = {6},
  number = {2},
  pages = {77-83},
  doi = {10.11648/j.ijn.20220602.18},
  url = {https://doi.org/10.11648/j.ijn.20220602.18},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijn.20220602.18},
  abstract = {This study aims to assess the efficacy and accuracy of a technique for posterior cervical decompression and fixation using high speed drill for posterior laminectomy and anatomical lateral mass screws placement. Background: Posterior cervical decompression through laminectomy is a well-known approach for surgical management of multiple levels cervical spondylosis with myelopathy, and ossification of the posterior longitudinal ligament (OPLL). Posterior decompression with lateral mass fixation helps to improve the clinical symptoms of those patients, in addition to improvement of their cervical curvature and range of motion. Methods: This is a retrospective study conducted from February 2019 to January 2021 included 30 patients with cervical myelopathy that underwent multiple levels posterior cervical laminectomy and lateral mass fixation using high speed drill. The primary outcomes measured in our study were Visual Analog Score (VAS) of neck pain and upper limbs pain, Japanese Orthopedic Association (JOA) score for assessment of cervical myelopathy for all those patients with comparison of preoperative and postoperative values up to 12 months after surgery. Secondary parameters assessed were perioperative complications, duration of surgical procedures, operative blood loss and hospital stay. Results: The included 30 patients in our study were 18 males (60%) and 12 females (40%), with mean age of 65.77 ± 5.056 years. Laminectomy and anatomical lateral mass screws placement using high speed drill approach showed average operative time of 119.83 ± 13.676 minutes, and minimal blood loss with mean 95.83 ± 14.389 ml. As regards VAS, our results showed marked improvement of postoperative VAS of neck pain 2.53 ± 0.73 and postoperative VAS of upper limbs 1.73 ± 0.828 at 12 months follow up in comparison to preoperative VAS values of neck pain 6.17 ± 1.51 and upper limbs 9.03 ± 0.85 with highly significant statistical difference value (P  0.001). In addition, there was significant improvement of Postoperative JOA score 15.06 ± 1.36 in comparison to preoperative values 9.56 ± 1.43, also with highly significant statistical difference (P  0.001). Conclusion: Posterior cervical decompression and fixation using high speed drill for Laminectomy and Anatomical lateral mass screws placement is an effective method for management of cases of cervical myelopathy with Favorable outcomes observed at 12 month follow up, with optimum operative time and minimal blood loss. However, a multicenter comparative study with long term follow-up is highly recommended.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Efficacy of Posterior Cervical Laminectomy and Fixation Technique Using High Speed Drill in Cervical Myelopathy
AU  - Ahmed Nagaty
AU  - Ahmad Elsabaa
AU  - Mohamed Helmy Abd Elshafouk
Y1  - 2022/10/11
PY  - 2022
N1  - https://doi.org/10.11648/j.ijn.20220602.18
DO  - 10.11648/j.ijn.20220602.18
T2  - International Journal of Neurosurgery
JF  - International Journal of Neurosurgery
JO  - International Journal of Neurosurgery
SP  - 77
EP  - 83
PB  - Science Publishing Group
SN  - 2640-1959
UR  - https://doi.org/10.11648/j.ijn.20220602.18
AB  - This study aims to assess the efficacy and accuracy of a technique for posterior cervical decompression and fixation using high speed drill for posterior laminectomy and anatomical lateral mass screws placement. Background: Posterior cervical decompression through laminectomy is a well-known approach for surgical management of multiple levels cervical spondylosis with myelopathy, and ossification of the posterior longitudinal ligament (OPLL). Posterior decompression with lateral mass fixation helps to improve the clinical symptoms of those patients, in addition to improvement of their cervical curvature and range of motion. Methods: This is a retrospective study conducted from February 2019 to January 2021 included 30 patients with cervical myelopathy that underwent multiple levels posterior cervical laminectomy and lateral mass fixation using high speed drill. The primary outcomes measured in our study were Visual Analog Score (VAS) of neck pain and upper limbs pain, Japanese Orthopedic Association (JOA) score for assessment of cervical myelopathy for all those patients with comparison of preoperative and postoperative values up to 12 months after surgery. Secondary parameters assessed were perioperative complications, duration of surgical procedures, operative blood loss and hospital stay. Results: The included 30 patients in our study were 18 males (60%) and 12 females (40%), with mean age of 65.77 ± 5.056 years. Laminectomy and anatomical lateral mass screws placement using high speed drill approach showed average operative time of 119.83 ± 13.676 minutes, and minimal blood loss with mean 95.83 ± 14.389 ml. As regards VAS, our results showed marked improvement of postoperative VAS of neck pain 2.53 ± 0.73 and postoperative VAS of upper limbs 1.73 ± 0.828 at 12 months follow up in comparison to preoperative VAS values of neck pain 6.17 ± 1.51 and upper limbs 9.03 ± 0.85 with highly significant statistical difference value (P  0.001). In addition, there was significant improvement of Postoperative JOA score 15.06 ± 1.36 in comparison to preoperative values 9.56 ± 1.43, also with highly significant statistical difference (P  0.001). Conclusion: Posterior cervical decompression and fixation using high speed drill for Laminectomy and Anatomical lateral mass screws placement is an effective method for management of cases of cervical myelopathy with Favorable outcomes observed at 12 month follow up, with optimum operative time and minimal blood loss. However, a multicenter comparative study with long term follow-up is highly recommended.
VL  - 6
IS  - 2
ER  -

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