Cervical laminoplasty as a management option for patients with cervical spondylotic myelopathy: a series of 40 patients.
BACKGROUND
Cervical spondylotic myelopathy (CSM) is one of the leading causes of spinal cord dysfunction in the adult population. Laminoplasty is an effective decompressive procedure for the treatment of CSM.


OBJECTIVE
We present our experience with 40 patients who underwent cervical laminoplasty using titanium miniplates for CSM.


METHODS
We performed a retrospective review of the medical records of a consecutive series of patients with CSM treated with laminoplasty at the University of Rochester Medical Center or Rochester General Hospital. We documented patient demographic data, presenting symptoms, and postoperative outcome. Data are also presented regarding the general cost of constructs for a hypothetical 3-level fusion.


RESULTS
Forty patients underwent cervical laminoplasty; all were available for follow-up. The mean number of levels was 4. All patients were myelopathic, and 17 (42.5%) had signs of radiculopathy preoperatively. Preoperatively, 62.5% of patients had a Nurick grade of 2 or worse. The average follow-up was 31.3 months. The median length of stay was 48 hours. On clinical evaluation, 36 of 40 patients demonstrated an improvement in their myelopathic symptoms; 4 were unchanged. Postoperative kyphosis did not develop in any patients.


CONCLUSIONS
The management of CSM for each of its etiologies remains controversial. As demonstrated in our series, laminoplasty is a cost-effective, decompressive procedure for the treatment of CSM, providing a less destabilizing alternative to laminectomy while preserving mobility. Cervical laminoplasty should be considered in the management of multilevel spondylosis because of its ease of exposure, ability to decompress, effective preservation of motion, maintenance of spinal stability, and overall cost.
Petraglia
Anthony L
AL
Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York 14642, USA. anthony_petraglia@urmc.rochester.edu
Srinivasan
Vasisht
V
Coriddi
Michelle
M
Whitbeck
M Gordon
MG
Maxwell
James T
JT
Silberstein
Howard J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D015331:Cohort Studies; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D013117:Spinal Cord Compression / Q000191:economics / Q000601:surgery*; D013131:Spine / Q000473:pathology; D055009:Spondylosis / Q000191:economics / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium