Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy

Introduction. Cervical compressive myelopathy manifests mainly as spastic paralysis, exaggerated reflexes, and clumsiness of the hand, with/without gait disturbances. It mainly results from degenerative changes in cervical spine along with infolding of the ligamentum flavum, the presence of spondyl...

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Main Authors: Ahmed Ansari, Faiz Khan Yusufi, Nikhil Wadhwan
Format: Article
Language:English
Published: London Academic Publishing 2024-12-01
Series:Romanian Neurosurgery
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Online Access:http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2896
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author Ahmed Ansari
Faiz Khan Yusufi
Nikhil Wadhwan
author_facet Ahmed Ansari
Faiz Khan Yusufi
Nikhil Wadhwan
author_sort Ahmed Ansari
collection DOAJ
description Introduction. Cervical compressive myelopathy manifests mainly as spastic paralysis, exaggerated reflexes, and clumsiness of the hand, with/without gait disturbances. It mainly results from degenerative changes in cervical spine along with infolding of the ligamentum flavum, the presence of spondylolisthesis, the development of osteophytes, and the hypertrophy of facet joints. Though the recent pathology appears to be facetal instability, hence facetal fixation with or without laminectomy in these patients should be advocated. Materials and Methods. 25 patients with cervical compressive myelopathy were operated with transfacet cervical spine fixation with or without laminectomy, decided on the basis of clinical symptomatology and MRI features. Results. All patients with laminectomy showed improved power and significant lightness in limbs post-surgery. In two patients, there was CSF leak, which was stopped by suture re-enforcing of the wound, and one patient required a lumbar drain to be kept for five days. One patient had a temporary deterioration of power in the left upper limb. Among patients undergoing only transfacet fixation, one patient had no change in symptoms, and three patients had a significant lightness in limbs. Conclusion. The decision to perform transfacet fixation with laminectomy versus transfacet fixation alone is based on the severity and type of spinal cord compression and the clinical presentation of the patient.
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spelling doaj-art-7431aea2684d457780d0174ae35071c82025-01-04T15:59:32ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592024-12-01384Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathyAhmed AnsariFaiz Khan YusufiNikhil Wadhwan Introduction. Cervical compressive myelopathy manifests mainly as spastic paralysis, exaggerated reflexes, and clumsiness of the hand, with/without gait disturbances. It mainly results from degenerative changes in cervical spine along with infolding of the ligamentum flavum, the presence of spondylolisthesis, the development of osteophytes, and the hypertrophy of facet joints. Though the recent pathology appears to be facetal instability, hence facetal fixation with or without laminectomy in these patients should be advocated. Materials and Methods. 25 patients with cervical compressive myelopathy were operated with transfacet cervical spine fixation with or without laminectomy, decided on the basis of clinical symptomatology and MRI features. Results. All patients with laminectomy showed improved power and significant lightness in limbs post-surgery. In two patients, there was CSF leak, which was stopped by suture re-enforcing of the wound, and one patient required a lumbar drain to be kept for five days. One patient had a temporary deterioration of power in the left upper limb. Among patients undergoing only transfacet fixation, one patient had no change in symptoms, and three patients had a significant lightness in limbs. Conclusion. The decision to perform transfacet fixation with laminectomy versus transfacet fixation alone is based on the severity and type of spinal cord compression and the clinical presentation of the patient. http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2896cervical compressive myelopathylaminectomytransfacet screw
spellingShingle Ahmed Ansari
Faiz Khan Yusufi
Nikhil Wadhwan
Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
Romanian Neurosurgery
cervical compressive myelopathy
laminectomy
transfacet screw
title Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
title_full Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
title_fullStr Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
title_full_unstemmed Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
title_short Subaxial transfacet fixation with/without laminectomy for cervical compressive myelopathy
title_sort subaxial transfacet fixation with without laminectomy for cervical compressive myelopathy
topic cervical compressive myelopathy
laminectomy
transfacet screw
url http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2896
work_keys_str_mv AT ahmedansari subaxialtransfacetfixationwithwithoutlaminectomyforcervicalcompressivemyelopathy
AT faizkhanyusufi subaxialtransfacetfixationwithwithoutlaminectomyforcervicalcompressivemyelopathy
AT nikhilwadhwan subaxialtransfacetfixationwithwithoutlaminectomyforcervicalcompressivemyelopathy