One-year results of 31 cases with Cervical MicroEndoscopic Laminectomy compared with Kurokawa laminoplasty
Introduction: CMEL (Cervical MicroEndoscopic Laminotomy) using a spinal endoscope has been reported as a surgical treatment for cervical myelopathy. In our department, we have introduced a modified version (CMEL) of laminectomy. This technique is minimally invasive, but the selective decompression a...
Saved in:
| Published in | Journal of Spine Research Vol. 13; no. 8; pp. 1005 - 1010 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Spine Surgery and Related Research
20.08.2022
一般社団法人 日本脊椎脊髄病学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1884-7137 2435-1563 |
| DOI | 10.34371/jspineres.2022-0801 |
Cover
| Abstract | Introduction: CMEL (Cervical MicroEndoscopic Laminotomy) using a spinal endoscope has been reported as a surgical treatment for cervical myelopathy. In our department, we have introduced a modified version (CMEL) of laminectomy. This technique is minimally invasive, but the selective decompression and discectomy may worsen the outcome compared with conventional treatment.Objective: To compare the 1-year results of the CMEL variant and the Kurokawa method in our department, and to clarify the usefulness and problems of the CMEL variant.Methods: The CMEL variant is a method of complete resection of the lamina between the open intervertebral space. The subjects were 31 cases of CMEL variant and 39 cases of Kurokawa method. The study items were operative time, blood loss, complications, postoperative hospital stay, JOA score before and 1 year after surgery, JOACMEQ, and neck pain NRS.Results: There was no difference in mean operative time. Mean blood loss was lower in the CMEL variant. There was no difference in JOA score before and after surgery, and no difference in JOACMEQ except for cervical spine function before surgery. There was no difference in neck pain NRS both preoperatively and postoperatively.Conclusions: The CMEL variant is an excellent technique with postoperative results comparable to those of the Kurokawa method, and also allows early discharge from the hospital due to its minimally invasive nature. |
|---|---|
| AbstractList | Introduction: CMEL (Cervical MicroEndoscopic Laminotomy) using a spinal endoscope has been reported as a surgical treatment for cervical myelopathy. In our department, we have introduced a modified version (CMEL) of laminectomy. This technique is minimally invasive, but the selective decompression and discectomy may worsen the outcome compared with conventional treatment.Objective: To compare the 1-year results of the CMEL variant and the Kurokawa method in our department, and to clarify the usefulness and problems of the CMEL variant.Methods: The CMEL variant is a method of complete resection of the lamina between the open intervertebral space. The subjects were 31 cases of CMEL variant and 39 cases of Kurokawa method. The study items were operative time, blood loss, complications, postoperative hospital stay, JOA score before and 1 year after surgery, JOACMEQ, and neck pain NRS.Results: There was no difference in mean operative time. Mean blood loss was lower in the CMEL variant. There was no difference in JOA score before and after surgery, and no difference in JOACMEQ except for cervical spine function before surgery. There was no difference in neck pain NRS both preoperatively and postoperatively.Conclusions: The CMEL variant is an excellent technique with postoperative results comparable to those of the Kurokawa method, and also allows early discharge from the hospital due to its minimally invasive nature.
はじめに：頚髄症に対する手術療法として脊椎内視鏡を使ったCMEL（Cervical MicroEndoscopic Laminotomy）が報告されている．当科では椎弓切除術に変更の上（CMEL変法）導入した．この術式は低侵襲であるが，選択的除圧および椎弓切除であることで，従来の治療法に比し治療成績悪化の危惧があり，治療成績の検討が必要である．目的：当科で行ったCMEL変法と黒川法の1年成績を比較検討し，CMEL変法の有用性，問題点を明らかにすることである．方法：CMEL変法は，開窓椎間の椎弓を完全に切除する方法である．対象はCMEL変法31例，黒川法39例である．検討項目は，手術時間，出血量，合併症，術後入院期間，術前と1年後のJOAスコアー，JOACMEQ，頚部痛NRSとした．結果：平均手術時間に差はなかった．平均出血量はCMEL変法の方が少なかった．術後入院期間はCMEL変法がより早期に退院していた．JOAスコアーは術前後ともに差がなかった．JOACMEQは，術前の頚椎機能以外は差がなかった．頚部痛NRSは，術前，術後ともに差がなかった．結論：CMEL変法は，黒川法と同等の術後成績であり，しかも低侵襲手術のため早期退院が可能な優れた術式である． Introduction: CMEL (Cervical MicroEndoscopic Laminotomy) using a spinal endoscope has been reported as a surgical treatment for cervical myelopathy. In our department, we have introduced a modified version (CMEL) of laminectomy. This technique is minimally invasive, but the selective decompression and discectomy may worsen the outcome compared with conventional treatment.Objective: To compare the 1-year results of the CMEL variant and the Kurokawa method in our department, and to clarify the usefulness and problems of the CMEL variant.Methods: The CMEL variant is a method of complete resection of the lamina between the open intervertebral space. The subjects were 31 cases of CMEL variant and 39 cases of Kurokawa method. The study items were operative time, blood loss, complications, postoperative hospital stay, JOA score before and 1 year after surgery, JOACMEQ, and neck pain NRS.Results: There was no difference in mean operative time. Mean blood loss was lower in the CMEL variant. There was no difference in JOA score before and after surgery, and no difference in JOACMEQ except for cervical spine function before surgery. There was no difference in neck pain NRS both preoperatively and postoperatively.Conclusions: The CMEL variant is an excellent technique with postoperative results comparable to those of the Kurokawa method, and also allows early discharge from the hospital due to its minimally invasive nature. |
| Author | Takahashi, Eiji Nakagawa, Tomowaki Hyoudo, Hironori Hoshikawa, Ken Tokunaga, Masako Sato, Tetsuro |
| Author_FL | 徳永 雅子 佐藤 哲朗 髙橋 永次 中川 智刀 兵藤 弘訓 星川 健 |
| Author_FL_xml | – sequence: 1 fullname: 中川 智刀 – sequence: 2 fullname: 髙橋 永次 – sequence: 3 fullname: 徳永 雅子 – sequence: 4 fullname: 星川 健 – sequence: 5 fullname: 兵藤 弘訓 – sequence: 6 fullname: 佐藤 哲朗 |
| Author_xml | – sequence: 1 fullname: Tokunaga, Masako organization: Department of Orthopaedic, Sendai Orthopaedic Hospital – sequence: 1 fullname: Hyoudo, Hironori organization: Department of Orthopaedic, Sendai Orthopaedic Hospital – sequence: 1 fullname: Nakagawa, Tomowaki organization: Department of Orthopaedic, Sendai Orthopaedic Hospital – sequence: 1 fullname: Sato, Tetsuro organization: Department of Orthopaedic, Sendai Orthopaedic Hospital – sequence: 1 fullname: Hoshikawa, Ken organization: Department of Orthopaedic, Sendai Orthopaedic Hospital – sequence: 1 fullname: Takahashi, Eiji organization: Department of Orthopaedic, Sendai Orthopaedic Hospital |
| BackLink | https://cir.nii.ac.jp/crid/1390856130155606016$$DView record in CiNii |
| BookMark | eNo9kDtPwzAUhS1UJErpP2DwwJri61ecEVXlIYq6dI8cx6EOaRzZKVX-PYmKupy7fOdc6btHs9a3FqFHICvGWQrPdexca4ONK0ooTYgicIPmlDORgJBshuagFE9SYOkdWsZYEzJyQEHyOap3rU0GqwMeB05NH7GvMANsdLQRn11_wGsbfp3RDf5yJvhNW_pofOcM3urj-Nj0_jhg44-dDra8VD5Pwf_os8bNhPiu0bEfHtBtpZtol_93gfavm_36Pdnu3j7WL9ukzoRMbMFIRkojRCGKrEwtJYUEQ0tWMFUpMBVkPMskVVRbngEjhnLCixKMJoVRbIGeLrOtc7lxUwLLiBJyZEEISSQBOWIfF6yOvf62eRfcUYch16F3prH51erYztUUk918sntlzEGH3LbsD1Had90 |
| ContentType | Journal Article |
| Copyright | 2022 Journal of Spine Research |
| Copyright_xml | – notice: 2022 Journal of Spine Research |
| DBID | RYH |
| DOI | 10.34371/jspineres.2022-0801 |
| DatabaseName | CiNii Complete |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| DocumentTitleAlternate | 内視鏡下椎弓切除術31例の術後1年成績―黒川式椎弓形成術との比較 |
| DocumentTitle_FL | 内視鏡下椎弓切除術31例の術後1年成績―黒川式椎弓形成術との比較 |
| EISSN | 2435-1563 |
| EndPage | 1010 |
| ExternalDocumentID | article_jspineres_13_8_13_2022_0801_article_char_en |
| GroupedDBID | .55 ALMA_UNASSIGNED_HOLDINGS JMI JSF JSH RJT RZJ X7M RYH |
| ID | FETCH-LOGICAL-j956-eb3090dc55b5b9d7e20b61c2d3b38f81cf194996282ae49130c2404bd1ca0bc83 |
| ISSN | 1884-7137 |
| IngestDate | Thu Jun 26 23:43:04 EDT 2025 Wed Sep 03 06:30:46 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 8 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j956-eb3090dc55b5b9d7e20b61c2d3b38f81cf194996282ae49130c2404bd1ca0bc83 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jspineres/13/8/13_2022-0801/_article/-char/en |
| PageCount | 6 |
| ParticipantIDs | nii_cinii_1390856130155606016 jstage_primary_article_jspineres_13_8_13_2022_0801_article_char_en |
| PublicationCentury | 2000 |
| PublicationDate | 2022/08/20 2022-08-20 |
| PublicationDateYYYYMMDD | 2022-08-20 |
| PublicationDate_xml | – month: 08 year: 2022 text: 2022/08/20 day: 20 |
| PublicationDecade | 2020 |
| PublicationTitle | Journal of Spine Research |
| PublicationTitleAlternate | J Spine Res |
| PublicationTitle_FL | Journal of Spine Research J Spine Res |
| PublicationYear | 2022 |
| Publisher | The Japanese Society for Spine Surgery and Related Research 一般社団法人 日本脊椎脊髄病学会 |
| Publisher_xml | – name: The Japanese Society for Spine Surgery and Related Research – name: 一般社団法人 日本脊椎脊髄病学会 |
| References | 11) 安藤 哲, 柳 務, 伊藤 高, 他: 頸椎症および頸椎後縦靱帯骨化症の頸椎動態MRI Dynamic compressionの意義. 臨床神経学. 1992; 32 (1): 30-36 4) 大谷 晃, 菊地 臣: 【頸椎症性脊髄症治療の進歩】頸椎症性脊髄症に対する頸椎椎弓骨切り術. 整形・災害外科. 2007; 50 (9): 991-998 5) 吉田 宗, 山田 宏, 麻殖生和, 他: 【整形外科における関節以外の内視鏡手術】頸椎疾患に対する後方進入内視鏡視下手術の展望. 整形・災害外科. 2004; 47 (12): 1461-1467 8) Minamide A, Yoshida M, Nakagawa Y, et al: Long-term Clinical Outcomes of Microendoscopic Laminotomy for Cervical Spondylotic Myelopathy: A 5-Year Follow-up Study Compared With Conventional Laminoplasty. Clin Spine Surg. 2021; 34 (10): 383-390 2) Hirabayashi K, Watanabe K, Wakano K, et al: Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine. 1983; 8 (7): 693-699 6) Minamide A, Yoshida M, Yamada H, et al: Clinical outcomes of microendoscopic decompression surgery for cervical myelopathy. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2010; 19 (3): 487-493 10) Shiraishi T: Skip laminectomy--a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report. The spine journal: official journal of the North American Spine Society. 2002; 2 (2): 108-115 12) 岩渕 真, 菊地 臣, 矢吹 省: 頸椎症性脊髄症に対するkinematic MRI有用性の検討. 臨床整形外科. 2005; 40 (1): 13-17 1) 黒川 高, 津山 直, 田中 弘: 頸椎症性脊髄症に対する棘突起縦割法脊柱管拡大術. 臨床整形外科. 1984; 19 (4): 483-490 7) Minamide A, Yoshida M, Yamada H, et al: Efficacy of Posterior Segmental Decompression Surgery for Pincer Mechanism in Cervical Spondylotic Myelopathy: A Retrospective Case-controlled Study Using Propensity Score Matching. Spine. 2015; 40 (23): 1807-1815 3) 山根 淳: 【頸椎症性脊髄症に対する手術治療戦略】筋温存型選択的椎弓切除術. 脊椎脊髄ジャーナル. 2019; 32 (11): 989-994 13) 有馬 亨: 椎弓切除後の頸椎柱の変化. 神経外傷. 1968; 1 (1): 71-78 9) 佐藤 勝, 菊地 臣: 頸椎症性脊髄症に対する椎弓骨切り術. 脊椎脊髄ジャーナル. 1995; 8 (2): 127-133 |
| References_xml | – reference: 12) 岩渕 真, 菊地 臣, 矢吹 省: 頸椎症性脊髄症に対するkinematic MRI有用性の検討. 臨床整形外科. 2005; 40 (1): 13-17 – reference: 2) Hirabayashi K, Watanabe K, Wakano K, et al: Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine. 1983; 8 (7): 693-699 – reference: 6) Minamide A, Yoshida M, Yamada H, et al: Clinical outcomes of microendoscopic decompression surgery for cervical myelopathy. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2010; 19 (3): 487-493 – reference: 10) Shiraishi T: Skip laminectomy--a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report. The spine journal: official journal of the North American Spine Society. 2002; 2 (2): 108-115 – reference: 11) 安藤 哲, 柳 務, 伊藤 高, 他: 頸椎症および頸椎後縦靱帯骨化症の頸椎動態MRI Dynamic compressionの意義. 臨床神経学. 1992; 32 (1): 30-36 – reference: 7) Minamide A, Yoshida M, Yamada H, et al: Efficacy of Posterior Segmental Decompression Surgery for Pincer Mechanism in Cervical Spondylotic Myelopathy: A Retrospective Case-controlled Study Using Propensity Score Matching. Spine. 2015; 40 (23): 1807-1815 – reference: 13) 有馬 亨: 椎弓切除後の頸椎柱の変化. 神経外傷. 1968; 1 (1): 71-78 – reference: 8) Minamide A, Yoshida M, Nakagawa Y, et al: Long-term Clinical Outcomes of Microendoscopic Laminotomy for Cervical Spondylotic Myelopathy: A 5-Year Follow-up Study Compared With Conventional Laminoplasty. Clin Spine Surg. 2021; 34 (10): 383-390 – reference: 1) 黒川 高, 津山 直, 田中 弘: 頸椎症性脊髄症に対する棘突起縦割法脊柱管拡大術. 臨床整形外科. 1984; 19 (4): 483-490 – reference: 4) 大谷 晃, 菊地 臣: 【頸椎症性脊髄症治療の進歩】頸椎症性脊髄症に対する頸椎椎弓骨切り術. 整形・災害外科. 2007; 50 (9): 991-998 – reference: 5) 吉田 宗, 山田 宏, 麻殖生和, 他: 【整形外科における関節以外の内視鏡手術】頸椎疾患に対する後方進入内視鏡視下手術の展望. 整形・災害外科. 2004; 47 (12): 1461-1467 – reference: 3) 山根 淳: 【頸椎症性脊髄症に対する手術治療戦略】筋温存型選択的椎弓切除術. 脊椎脊髄ジャーナル. 2019; 32 (11): 989-994 – reference: 9) 佐藤 勝, 菊地 臣: 頸椎症性脊髄症に対する椎弓骨切り術. 脊椎脊髄ジャーナル. 1995; 8 (2): 127-133 |
| SSID | ssj0002212164 ssib058493330 ssib043658114 ssib044745754 |
| Score | 2.318628 |
| Snippet | Introduction: CMEL (Cervical MicroEndoscopic Laminotomy) using a spinal endoscope has been reported as a surgical treatment for cervical myelopathy. In our... |
| SourceID | nii jstage |
| SourceType | Publisher |
| StartPage | 1005 |
| SubjectTerms | Cervical MicroEndoscopic laminotomy Kurokawa method MicroEndoscopic surgery 内視鏡下手術 頚椎内視鏡下椎弓切離術 黒川法 |
| Title | One-year results of 31 cases with Cervical MicroEndoscopic Laminectomy compared with Kurokawa laminoplasty |
| URI | https://www.jstage.jst.go.jp/article/jspineres/13/8/13_2022-0801/_article/-char/en https://cir.nii.ac.jp/crid/1390856130155606016 |
| Volume | 13 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Journal of Spine Research, 2022/08/20, Vol.13(8), pp.1005-1010 |
| journalDatabaseRights | – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 2435-1563 dateEnd: 99991231 omitProxy: true ssIdentifier: ssib044745754 issn: 1884-7137 databaseCode: M~E dateStart: 20200101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Nb9MwFLfKuHBBIEAMGPKBW5Vix87XkU1FE2NwWJF2i2wngaRtXG2tpu3Av8K_yntxkqZTJT4uVuvmw_H79fn3kvd7IeRdwaJMAFH1eGJ8T5qYe-DzAq-QUuuchfjsDrMtvoSn3-Sny-ByNPo1yFrarPXE3O3VlfyPVaEP7Ioq2X-wbH9Q6IDPYF9owcLQ_pWNv9a5d4uVeCBm3ixcVobgYwMrU6taO2lcAepvMfFuWmcWZSilGX9WS-CXZm2Xt_fy0M82V3aubtR4gZvYFdDr9c6z3wGHvVghSe2y9_oby2quvuMRZnZpb4Cibm8PzFFB9qMcT8tq22vnmxp2GJ-razW3PdAsbNgM5KyVq7U3JyCuZWihHk6NvA0WfXyZ5k4aqhvehVN-t1LMhUKOvTNk55PjGFNGXW2YSd70-cDyPAg9xY4jFwPAxgOvzBkLBis8eCG2b_UQUkTN8nGNowPLTdpLQn3gQz8KQ3xFxvnPaeewpAD-xrePoaWMJNDf_juQu0SINj6rmlpD3HclzfqLcnLO5tTv95wYiFEFYQLWf3hQl-WA-8yekMetwekHh8CnZFSpZ6Tq0Edb9FFbUMFpgz6KUKId-ug99NEB-miHPrdLhz46RN9zMvs4nZ2ceu2bO7wK61rmWrCEZSYIdKCTLMp9pkNu_ExoERcxNwXHmkghhPsqlwnQKAPEUuqMG8W0icULclDbOn9JaJzzoPBznfgZ7GJCBfGyySJWMCGBirNDcuzmJ1256ixp-29M-8lMuUhjbHBSU5zUfhtUNoIjOSRHMLepKbGFkAjCEAyrgWqHTbmiV3_4_TV5tAX_G3KwvtrkR8BV1_ptg5ffQqOUVA |
| linkProvider | ISSN International Centre |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=One-year+results+of+31+cases+with+Cervical+MicroEndoscopic+Laminectomy+compared+with+Kurokawa+laminoplasty&rft.jtitle=Journal+of+Spine+Research&rft.au=Nakagawa+Tomowaki&rft.au=Takahashi+Eiji&rft.au=Tokunaga+Masako&rft.au=Hoshikawa+Ken&rft.date=2022-08-20&rft.pub=The+Japanese+Society+for+Spine+Surgery+and+Related+Research&rft.issn=1884-7137&rft.eissn=2435-1563&rft.volume=13&rft.issue=8&rft.spage=1005&rft.epage=1010&rft_id=info:doi/10.34371%2Fjspineres.2022-0801 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1884-7137&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1884-7137&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1884-7137&client=summon |