Laminoplasty following anterior cervical fusion for spondylotic myeloradiculopathy

Abstract

Eighteen patients with spondylotic myeloradiculopathy who had undergone expansive laminoplasty after anterior cervical fusion were reviewed. The average period from the initial to the second operation was 7.8 years. Excellent neurological improvement occurred in 4 patients, good in 6, fair in 4 and poor in 4. Radiographs at the time of the second operation showed spinal canal stenosis in 11, and 12 showed dynamic spinal canal stenosis immediately above the fused area. A narrow spinal canal adds to the risk of recurrence. When spinal stenosis is treated by anterior cervical fusion, additional laminoplasty should be carried out to prevent structural compromise occurring adjacent to the fused vertebrae.

The cervical spine in the Klippel-Feil syndrome

“…We advocate laminoplasty for symptomatic mid-and lower cervical spondylosis. This has the advantage of both decompression and the preservation of some cervical movement [2]. Patients should be assessed at intervals to determine whether they fulfil these indications [22,24].…”

Treatment of Cervical Adjacent Segment Pathology

“…5 , 6 Clinical outcome based on Japanese Orthopaedic Association score recovery rate was reported in both studies with 38% of the patients being categorized as having excellent or good outcome in the largest study 6 and 55% in the smaller study. 5 Operative indication reportedly did not infl uence recovery rate in the larger study, but results from the smaller study suggest otherwise ( Table 3 ).…”

Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy

“…The operation increases the size of the bony canal, preserves the posterior elements, allows the spinal cord and nerve roots to move away from the vertebral spondylotic lesion and maintains the range of neck movement. The disadvantage of multilevel anterior fusion is that additional posterior salvage operations may be required because of high mechanical demands on the segments which are not fused [2]. Laminoplasty is thus highly recommended as the initial treatment of choice.…”