title: Axial symptoms after cervical laminoplasty with C3 laminectomy compared with conventional C3-C7 laminoplasty: a modified laminoplasty preserving the semispinalis cervicis inserted into axis.
abstract: METHODS
  Results of C4-C7 laminoplasty with C3 laminectomy and C3-C7 laminoplasty were compared.
  
  
  OBJECTIVE
  To clarify prospectively whether the modified laminoplasty preserving the semispinalis cervicis inserted into C2 could reduce the axial symptoms compared with conventional laminoplasty reattaching the muscle to C2.
  
  
  BACKGROUND
  Intraoperative damage of the semispinalis cervicis is relevant to the development of axial symptoms after laminoplasty. In C3-C7 laminoplasty, however, it is difficult to preserve the muscle insertion into C2 while opening the C3 lamina.
  
  
  METHODS
  The axial symptoms of 40 patients (Group A) with C4-C7 laminoplasty with C3 laminectomy were compared with those of 16 patients (Group B) with C3-C7 laminoplasty. The cross-sectional areas of the cervical posterior muscles were measured on magnetic resonance images.
  
  
  RESULTS
  The number of patients with no postoperative axial symptoms increased (P = 0.035) from 19% to 52.5%, and the number of patients whose symptoms worsened after surgery decreased (P = 0.020) from 50% to 17.5%. The average atrophy rate of cross-sectional area was smaller (P < 0.001) in Group A (2.4%) than in Group B (10.8%).
  
  
  CONCLUSIONS
  This method was less invasive to the cervical posterior muscles than C3-C7 laminoplasty. This is an effective procedure for preventing postoperative axial symptoms.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Hirosaki, Japan. naritake03@ybb.ne.jp
authors.forename: Kazunari
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Toru
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Aburakawa
authors.forename: Akira
authors.initials: A
authors.lastname: Saito
authors.forename: Takuya
authors.initials: T
authors.lastname: Numasawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Taito
authors.initials: T
authors.lastname: Itabashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Okada
authors.forename: Junji
authors.initials: J
authors.lastname: Ito
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Ueyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008875:Middle Aged; D009133:Muscular Atrophy / Q000517:prevention & control*; D009334:Neck Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D012720:Severity of Illness Index; D013118:Spinal Cord Diseases / Q000601:surgery*; D016896:Treatment Outcome