Summary:
Cervical open door laminoplasty has been used for over 20 years. We operated 20 patients (16 men, 4
women) with cervical spinal myelopathy (CSM) and 6 patients with relative cervical spinal canal
stenosis due to intramedullary expansion process since March 1999 to December 2002 (46 months). All
these patients underwent the bilateral hinge French-door laminoplasty. The retrospective analysis
investigated a minimum of 6–12 months of follow-up of CSM group regarding subjective and clinical
changes (Nurick score) before and after surgery, neck pain, neck movement, bone grafts fusion and
changes of anteroposterior diameter spinal canal/vertebral body ratio (SC/VB ratio). In CSM group 7
patients had performed decompression from the anterior approach as the first step. Improvement after
surgery in long term follow-up was described by 16 patients (80 %). They reported subjective improvement
in strength, dexterity, sensation, pain, gait and better bladder function. In comparison the Nurick
score was improved in 12 patients (60 %) and was unchanged in 7 (35 %) but without worsening of the
CSM in the follow-up. One patient (5 %) was slightly worsened. Neck movement was reducedminimally
especially in rotations and lateral bending in majority of our patients. Neck pain was diminished in 11
patients, was unchanged in 6 and was worsened in 3. Mean SC/VB ratio as measured by CT scans was
enlarged from preoperative 0.625 to postoperative 0.880. Extension of decompresion was C3–C6 or
C3–C7 in most of patients. The fusion of bone grafts was reached in 80% of all inserted (57).Laminoplasty
techniques achieved the preservation of posterior part of cervical spine which is necessary for its
protective function with no postoperative malalignment and maintenance of decompressive effect that
avoids recurrent stenosis and late kyphosis. These are main advantages which suggests that laminoplasty is preferable to laminectomy as a procedure for multilevel CSM. The recovery rate after various
laminoplasties is reported to range from 50% to 70% and our results are fully in correspondence with
these reports. Six patients who were operated for relative stenosis of cervical spine were evaluated
individually.
Key words:
cervical myelopathy, decompression, laminectomy, laminoplasty
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