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Minimum invasive posterior decompression for cervical spondylotic amyotrophy

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Cervical spondylotic amyotrophy (CSA), characterized by amyotrophy and muscular weakness of the upper limbs, is caused by damage to anterior spinal root or anterior horn of the spinal cord. Formerly, anterior decompression and fusion were performed for treatment of CSA, but it has recently been reported that posterior decompression is also effective. However, a consensus on the choice of procedure has not yet been reached. Selective laminoplasty as minimally invasive surgery is a posterior decompression procedure that alleviates axial neck pain. Because, for CSA patients, the responsible lesion level is localized, this procedure combined with foraminotomy enables simultaneous spinal cord and root decompression. Therefore, we report the results of this treatment for CSA.

Methods

Subjects were 28 patients (25 males, 3 females), average age 50.6 years and average follow-up 43.5 months. The muscles involved were deltoid for 14 patients, biceps for 11, and extensor digitorum communis and/or intrinsic muscles of the hand for 9. MMT scores were grade 2 for 23 cases and grade 3 for 5 cases. To evaluate the results of minimally invasive surgery, cervical ROM (C2–7) and postoperative neck pain (VAS) on the first postoperative day and 1 week after surgery were evaluated.

Results

Muscle strength improvement was rated as “excellent” for 18 patients, “good“ for 9, and “fair” for 1, with none rated “poor”. Four of 10 patients whose muscle strength did not fully improve had distal type CSA and/or had preoperative MMT scores of 2. Average %ROM was 91.2 % and almost complete cervical ROM was maintained. The average postoperative VAS score was 2.6 on the first postoperative day and 1.2 1 week after surgery.

Conclusions

Selective laminoplasty with segmental decompression is advantageous for minimizing postoperative neck pain and for simultaneous decompression of the affected spinal cord segment and nerve root.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 064-8543, Japan

    Tsuneo Takebayashi, Mitsunori Yoshimoto, Kazunori Ida, Hajime Tsuda, Yoshinori Terashima & Toshihiko Yamashita

Authors
  1. Tsuneo Takebayashi
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  2. Mitsunori Yoshimoto
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  3. Kazunori Ida
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  4. Hajime Tsuda
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  5. Yoshinori Terashima
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  6. Toshihiko Yamashita
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Corresponding author

Correspondence to Tsuneo Takebayashi.

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Takebayashi, T., Yoshimoto, M., Ida, K. et al. Minimum invasive posterior decompression for cervical spondylotic amyotrophy. J Orthop Sci 18, 205–207 (2013). https://doi.org/10.1007/s00776-012-0330-9

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  • DOI: https://doi.org/10.1007/s00776-012-0330-9

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