FIGURES AND TABLES
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Laminectomy for cervical myelopathy
N E Epstein
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Figure 1.
Preoperative midline sagittal 3D-CT study demonstrates congenital cervical stenosis with an AP canal diameter of less than 10 mm from C3 to C7. Note, shingling of the laminae (single arrows) contributing to marked dorsal-lateral cord compression
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Figure 2.
Trans-axial myelo-CT examination shows congenital stenosis, ventral OPLL (triple arrows), and dorsal–lateral laminar shingling (double arrows) contributes to multilevel cord compression
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Figure 3.
Laminectomy accompanied by medial facetectomy and foraminotomy (curved arrows) involves the C3–C6 levels (single arrows) with undercutting of the inferior C7 lamina particularly in the midline (double arrows)
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Figure 4.
A 6-month postoperative 3D-CT study clearly demonstrates a moderate residual ventral bony intrusion in the lower cervical canal (triple arrows), while clearly defining the adequacy of the lateral margins of the bony laminectomy defect (double arrows)
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Figure 5.
This T2-weighted midline sagittal MR examination, obtained 2 years following a multilevel cervical laminectomy from C3 to C6 shows significant cord atrophy (double arrows) most evident opposite the C3–C4 levels (white arrow). Pre-operatively, the patient had exhibited maximal cord compression accompanied by an increased signal in the cord opposite this level
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Figure 6.
This 72-year-old female patient with cervical stenosis and a C4–C5 subluxation, had a C3–C5 laminectomy (six small arrows) with posterior C2 spinous process, C3–C5 facet, and C6 spinous process wiring and fusion performed using braided titanium cables (double arrows) and autograft bone. A 6-month postoperative extension lateral radiograph showed no increased motion at the site of preoperative olisthy (single arrow)
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Figure 7.
A 6-month postoperative midline sagittal 3D-CT examination also showed no increased olisthy opposite the C4–C5 level (single arrow) and the titanium cable from C2 to C6 remained intact (double arrows). Additional parasagittal views demonstrated fusion across the C2–C6 facet joints
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Figure 8.
Illustration of a multilevel facet wiring and fusion following a C3–C6 cervical laminectomy, requiring the placement of a braided titanium cable (single arrows) through the inferior articular facets of the C2–C7 lamina, followed by passing each cable through a hole created in a split fibula allograft (double arrows). After the facet joints are packed with autologous bone and demineralized bone matrix, the cable may then be hand-tightened and crimped at each respective level
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