Safety and stability of open-door cervical expansive laminoplasty.
Cervical expansive laminoplasty has been utilized for over 20 years. This retrospective analysis investigated the safety and incidence of postoperative instability of patients undergoing a modified expansive laminoplasty. One hundred five patients underwent a modified cervical expansive laminoplasty and had at least a 6-month follow-up. These 105 patients were followed for a mean of 18.6 months (range 6-89 months). All patients remained in a rigid cervical collar for 8-12 weeks after the laminoplasty. Postoperative cervical plain radiographs were obtained on postoperative day 1, an average of 9.6 weeks postoperatively (range 8-12 weeks) and an average of 10.1 months (range 6-12 months) postoperatively. Thirty-five patients underwent further radiographs >18 months postoperatively. Laminoplasty was performed in 82 patients with progressive cervical spondylotic myelopathy, 4 patients with ossification of the posterior longitudinal ligament, 7 patients for posterior approach to a cervical neoplasm, and 12 patients for early posttraumatic decompression. The canal/vertebral body ratio showed a significant increase from 0.78 to 1.02 (paired t test, p < 0.001). Postoperatively, no incidence of graft dislodgement or segmental instability was diagnosed in any patient. Modified open-door expansive laminoplasty is an effective way of expanding the spinal canal. Its associated low incidence of postoperative instability and kyphotic deformity should make this procedure a desirable substitute for cervical laminectomy under many circumstances.
Lee
T T
TT
Department of Neurological Surgery, University of Miami School of Medicine, Florida 33101, USA.
Green
B A
BA
Gromelski
E B
EB
D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000592:standards*; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D012272:Ribs / Q000637:transplantation; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000601:surgery; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome