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PROSPECTIVE STUDY
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 77-80

Laminoplasty for cervical spondylotic myelopathy


Doctor (MD), Brussels Neurosurgery Center, Clinique du Parc Léopold, Brussels, Belgium

Correspondence Address:
Patrick Fransen
Brussels Neurosurgery Center, Clinique du Parc Léopold, 38 rue Froissart 1040, Brussels
Belgium
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1015

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Cervical spondylotic myelopathy (CSM) is a commonly treated either by uninstrumented laminectomy, carrying the risk of postoperative instability, or by anterior or posterior decompression with fusion resulting in postoperative stiffness and possibly adjacent segment degeneration. Cervical laminoplasty, initially developed for pediatric or OPLL patients could be an interesting surgical alternative to decompress and reconstruct cervical anatomy without fusion. Sixteen patients, mean age 63, who presented with CSM were treated surgically using multilevel laminoplasty, and reviewed after 1 month, 6 months, 1 and 2 years. Clinical evaluation was performed based on the Benzel-JOA and Nurick scores. The preoperative mean Benzel-JOA score was 13.43; preoperative mean Nurick score was 1.81. Intramedullary hyperintensity in T2 MRI was observed in five patients. The operation was performed on 2 levels (19%) 3 levels (69%) and 4 levels (12%). We used the open-door hinged laminoplasty technique, using metallic implants, without bone graft. At one month FU, mean JOA score was 15.44, and Nurick dropped to 1.05. At 6 months, mean JOA was 16.36 and Nurick was 0.72. At one year, the mean JOA score was 16.16, and Nurick was 0.83. At 2 years, mean JOA was 17.5 and Nurick was 0.25. We reviewed the possible advantages and complications of spinal cord decompression by open-door laminoplasty for CSM. We conclude that this technique allows significant clinical improvement observed progressively in the two years following surgery without increased rigidity or instability.


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