Spinal Cord Diseases Clinical Trial
Official title:
Comparison of Cervical Laminectomy to Cervical Laminoplasty* in Patients With Cervical Myelopathy or Myeloradiculopathy Due to Multiple Level Cervical Spinal Canal Stenosis * ARCHâ„¢ Fixation System by SYNTHES
The objective of this study is to compare the clinical and radiographic outcomes of multi-level laminectomy to multi-level laminoplasty in the treatment of patients with cervical myelopathy or myeloradiculopathy. The hypothesis for the study is that the laminoplasty group is not inferior to the laminectomy group.
Historically, cervical laminectomy has been proven to be effective in the treatment of
symptomatic patients with cervical myelopathy. This standard procedure is employed to
accomplish posterior decompression of the cervical spinal cord in patients with multi-level
cervical spinal stenosis who have normal or near normal cervical spinal curvature and
alignment without associated instability. Laminoplasty was developed in Japan as an
alternative to the laminectomy procedure with the intent to reduce post-operative morbidity
after dorsal cervical spinal cord decompression, neck pain and to maintain the relative
stability of the cervical spine after multi-level decompression.
The goal of both the laminoplasty and laminectomy procedures is to provide spinal cord
decompression by enlargement of the spinal canal. A potential benefit of laminoplasty
compared to laminectomy is to preserve stability and range of motion of the cervical spine
without complete disruption/removal of the posterior laminae, spinous processes and
interspinous ligamentous structures. Various authors have described different laminoplasty
techniques; all preserve the lamina and expand the size of the spinal canal by fixing the
freed or partially freed lamina in a more posterior position.
The primary study hypothesis is that, patients treated with laminoplasty with ARCH fixation
(Treatment Group) have clinical and radiographic outcomes as assessed by valid outcomes
measures, is not inferior to patients treated with laminectomy (Control Group)
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