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Symptomatic cord compression by paraspinal musculature following cervical laminectomy: rare complication

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Abstract

Purpose

Cervical laminectomy is an effective treatment for multilevel cervical compressive myelopathy. Symptomatic spinal cord compression (SSCC) by paraspinal musculature (PSM) following cervical laminectomy is rarely reported. The aim of this study was to evaluate the frequency and pathogenesis of this complication after cervical laminectomy.

Methods

Between 2007 and 2016, the medical records of 1309 cervical laminectomy patients were reviewed. From these 1309 records, seven patients (five men and two women; average age, 64.12 years; range 48–78 years) with SSCC by PSM following cervical laminectomy were identified. The incidence and possible risk factors of this rare condition were evaluated.

Results

The frequency of SSCC by PSM following cervical laminectomy was 0.53%. Presenting symptoms included paralyses and paresthesias, depending on the level and severity of cervical spinal cord compression. The initial onset of neurologic deterioration varied from 12 h to 21 days after operation. Most patients recovered well after surgical management with an average Barthel index of 74.3 at 6 months after surgery. In comparison with 63 controls, this rare complication was associated with preoperative cervical kyphosis, prior antiplatelet therapy, and posterior decompression with prone position.

Conclusions

SSCC by PSM is a rare but devastating complication following cervical laminectomy, especially in those patients with preoperative kyphosis, prior antiplatelet treatment, and decompression with prone position. MRI is an ideal tool to identify this complication. Rapid cervical cord decompression and avoidance of recurrent compressive events can achieve a good clinical outcome.

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Acknowledgements

We acknowledge the generous support of Chang Gung Memorial Hospital, Taiwan (CMRPG3D0751).

Funding

The study was found CMRPG3D0751.

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Authors and Affiliations

  1. Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung Medical College and University, 5, Fu-Shin Street, Kwei-Shan Hsiang, Taoyuan, 333, Taiwan

    Po-Hsun Tu, Chun-Ting Chen, Ching-Chang Chen, Jyi-Feng Chen, Chieh-Tsai Wu, Kuo-Chen Wei & Zhuo-Hao Liu

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  1. Po-Hsun Tu
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Correspondence to Zhuo-Hao Liu.

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Tu, PH., Chen, CT., Chen, CC. et al. Symptomatic cord compression by paraspinal musculature following cervical laminectomy: rare complication. Eur Spine J 27, 1815–1823 (2018). https://doi.org/10.1007/s00586-018-5685-y

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  • DOI: https://doi.org/10.1007/s00586-018-5685-y

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