Instrumented open-door laminoplasty as treatment for cervical myelopathy in 104 patients.
Treatment of multilevel cervical myelopathy remains a challenge. We report on a large series of cervical myelopathy patients treated with instrumented open-door laminoplasty. We retrospectively examined the medical records of 104 patients who had undergone instrumented open-door laminoplasty (titanium plate) for cervical myelopathy (minimum follow-up, 24 months). All patients had been myelopathic, 57 (54.8%) had stenosis, 39 (37.5%) had spondylosis, 66 (63.5%) reported gait disturbance, 18 (17.3%) had handwriting changes, 33 (31.7%) complained of deterioration of dexterity, 56 (53.8%) had grasp weakness, 7 (6.7%) had bowel and bladder complaints, 27 (26.0%) had a positive Hoffmann sign, 10 (9.6%) had sustained clonus, and 10 (9.6%) had a positive Babinski sign. Mean preoperative-to-postoperative improvement in Nurick grade was 1.47. Complications included 4 nerve root injuries (3.8%), 1 of which (at C5) was permanent, and 1 transient neurologic deterioration (<1%), 1 incidental durotomy (<1%), and 5 wound infections (4.8%). Four patients required anterior revision for persistent symptoms. Open-door laminoplasty with miniplate instrumentation is an effective, safe method for preventing progression of myelopathy with multilevel involvement while alleviating the need for multilevel fusion.
Dimar
John R
JR
Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, KY 40202, USA.
Bratcher
Kelly R
KR
Brock
Dylan C
DC
Glassman
Steven D
SD
Campbell
Mitchell J
MJ
Carreon
Leah Y
LY
D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000503:physiopathology / Q000601:surgery; D013118:Spinal Cord Diseases / Q000503:physiopathology / Q000601:surgery*; D013130:Spinal Stenosis / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome