Laminectomy and fusion for the treatment of cervical degenerative myelopathy.
OBJECTIVE
The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminectomy and fusion for the treatment of cervical spondylotic myelopathy (CSM).


METHODS
The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminectomy, fusion, and CSM. Abstracts were reviewed, after which studies that met the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Class I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations which contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer-review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons.


RESULTS
Cervical laminectomy with fusion (arthrodesis) improves functional outcome in patients with CSM and ossification of the posterior longitudinal ligament (OPLL). Functional improvement is similar to laminectomy or laminoplasty for patients with CSM and OPLL. In contrast to laminectomy, cervical laminectomy with fusion it is not associated with late deformity (Class III).


CONCLUSIONS
Laminectomy with fusion (arthrodesis) is an effective strategy to improve functional outcome in CSM and OPLL.
Anderson
Paul A
PA
Department of Orthopaedic Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Matz
Paul G
PG
Groff
Michael W
MW
Heary
Robert F
RF
Holly
Langston T
LT
Kaiser
Michael G
MG
Mummaneni
Praveen V
PV
Ryken
Timothy C
TC
Choudhri
Tanvir F
TF
Vresilovic
Edward J
EJ
Resnick
Daniel K
DK
D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D020127:Recovery of Function; D013118:Spinal Cord Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome