Degenerative Cervical Myelopathy
Conditions
Interventions
Group A (absorbable suture group): At the index cervical laminoplasty, polyglactin 910 (VICRYL) USP 2 will be used for closure of the deep layer, defined as the nuchal ligament and contiguous midline
Sponsors
Japan Community Healthcare Organization Osaka Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients scheduled to undergo elective cervical laminoplasty at our institution. 2. Age >=20 years. 3. Patients diagnosed with degenerative cervical myelopathy (primarily cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament, or cervical disc herniation) and deemed suitable for laminoplasty. 4. Patients who have provided written informed consent. 5. The standard surgical procedure is laminoplasty from C3 to C6 with or without C7 cephalic dome-like laminotomy. 6. Permitted additional procedures include caudal or ventral decompression at C2, concomitant foraminotomy, and conversion to laminectomy for up to two laminae.
Exclusion criteria
Exclusion criteria: 1. Patients undergoing revision surgery. 2. Patients in whom non-degenerative conditions, such as infection, tumor, or trauma, are the primary pathology. 3. Patients in whom identification of posterior supporting structures or standardized deep layer closure is expected to be markedly difficult (e.g., due to severe scarring). 4. Patients deemed inappropriate for inclusion by the principal investigator. 5. Patients undergoing additional procedures at the laminoplasty levels, including C1 posterior arch resection, procedures involving detachment of muscles attached to C2, or resection of the C7 spinous process, as well as those requiring conversion to laminectomy involving three or more laminae.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Neck pain at 3 months postoperatively, assessed using the 0-100 mm Visual Analog Scale (VAS) | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Nuchal ligament continuity at 6 months postoperatively, assessed on MRI (presence or absence of disruption and the involved level) 2. Neck pain assessed using the 0-100 mm Visual Analog Scale (VAS) preoperatively and at 1, 6, and 12 months postoperatively 3. JOA score, JOACMEQ, EQ-5D, SF-8, and patient satisfaction with surgery assessed preoperatively and at 3, 6, and 12 months postoperatively 4. Radiographic parameters assessed on plain radiographs preoperatively and at 3, 6, and 12 months postoperatively: C2-7 lordosis, T1 slope, C2-7 sagittal vertical axis (C2-7 SVA), and C2-7 range of motion (C2-7 ROM) 5. Wound findings at 1 month postoperatively (+/- 2 weeks) (presence or absence of redness, swelling, discharge, and dehiscence) and skin incision length measured in the neutral position 6. Wound-related complications up to 12 months postoperatively (SSI, hematoma, seroma, wound dehiscence, and suture-related local reactions) and reoperation related to the index surgery | — |
Countries
Japan
Contacts
Public ContactShota Takenaka
Japan Community Healthcare Organization Osaka Hospital Department of Orthopaedic Surgery
Outcome results
None listed