cervical laminectomy and fusion
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Cervical Laminectomy and Fusion Andrew K. Simpson, MD Cervical - PowerPoint PPT Presentation

Cervical Laminectomy and Fusion Andrew K. Simpson, MD Cervical Laminectomy and Fusion The best treatment option for multilevel cervical stenosis (3 levels) without kyphosis Multilevel Cervical Stenosis Treatments Anterior Posterior


  1. Cervical Laminectomy and Fusion Andrew K. Simpson, MD

  2. Cervical Laminectomy and Fusion The best treatment option for multilevel cervical stenosis (≥3 levels) without kyphosis

  3. Multilevel Cervical Stenosis Treatments Anterior Posterior –Laminoplasty –ACDF –Laminectomy –ACDF +/- and Fusion Corpectomy Combined A/P

  4. Multilevel Cervical Stenosis Treatments Anterior Posterior –ACDF –Laminoplasty –ACDF +/- –Laminectomy and Corpectomy Fusion –Disc Arthroplasty –MIS Laminotomy –Skip Laminectomy Combined A/P

  5. The Good News is Everything Works

  6. The Good News is Everything Works But there is a best answer for a particular patient…

  7. ACDF • 1-2 levels of stenosis (3 if low pseudo risk +/- ICBG) • +/- kyphosis • Corpectomy 1 level Lowest Fusion Rate ≥ 3 Levels

  8. Anteroposterior • Deformity • Multilevel Anterior Procedure Required – High pseudo risk – Still need dorsal decompression (retrovertebral stenosis) Highest Complication Rate

  9. Lami / Fusion vs Laminoplasty The Evidence Lami / Fusion and Laminoplasty similar efficacy

  10. Lami / Fusion vs Laminoplasty The Evidence Lami / Fusion with slightly greater neurological improvement, but slightly higher long-term complication

  11. Lami / Fusion vs Laminoplasty The Evidence Lami /Fusion causes regression of ventral compressive structures

  12. Cervical Laminectomy and Fusion in my practice…

  13. Ideal Cervical Laminectomy and Fusion Patient #1 – > 3 level stenosis – Spondylotic with decrease pre-op ROM – Neutral subaxial cervical alignment – C2-C7 SVA >30mm

  14. Ideal Cervical Laminectomy and Fusion Patient #1

  15. Ideal Cervical Laminectomy and Fusion Patient #2 – Congenital Stenosis – Previous ACDF with persistent stenosis at level of ACDF and adjacent – Pseudo

  16. Ideal Cervical Laminectomy and Fusion Patient #2

  17. In the end, go with what you know Laminoplasty and Lami / Fusion outcomes are similar enough that you should do what you know best…

  18. But for me… Young Myelopathic Patient ≥ 3 Levels Stenosis Congenital Canal Narrowing Acceptable Alignment Secondary or No Neck Pain

  19. But for me…

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