Cervical laminoplasty for the treatment of cervical degenerative myelopathy.
OBJECTIVE
The objective of this systematic review was to use evidence-based medicine to examine the efficacy of cervical laminoplasty in the treatment of cervical spondylotic myelopathy (CSM).


METHODS
The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to cervical laminoplasty and CSM. Abstracts were reviewed and studies meeting the inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons and Congress of Neurological Surgeons.


RESULTS
Cervical laminoplasty has improved functional outcome in the setting of CSM or ossification of the posterior longitudinal ligament. Using the Japanese Orthopaedic Association scale score, approximately 55-60% average recovery rate has been observed (Class III). The functional improvement observed after laminoplasty may be limited by duration of symptoms, severity of stenosis, severity of myelopathy, and poorly controlled diabetes as negative risk factors (Class II). There is conflicting evidence regarding age, with 1 study citing it as a negative risk factor, and another not demonstrating this result.


CONCLUSIONS
Cervical laminoplasty is recommended for the treatment of CSM or ossification of the posterior longitudinal ligament (Class III).
Matz
Paul G
PG
Division of Neurological Surgery, University of Alabama, Birmingham, Alabama, USA. matzpg@yahoo.com
Anderson
Paul A
PA
Groff
Michael W
MW
Heary
Robert F
RF
Holly
Langston T
LT
Kaiser
Michael G
MG
Mummaneni
Praveen V
PV
Ryken
Timothy C
TC
Choudhri
Tanvir F
TF
Vresilovic
Edward J
EJ
Resnick
Daniel K
DK
D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects; D017887:Ossification of Posterior Longitudinal Ligament / Q000175:diagnosis / Q000601:surgery; D011379:Prognosis; D020127:Recovery of Function; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000601:surgery*; D055009:Spondylosis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome