title: Anterior cervical multilevel decompression and fusion using fibular strut as revision surgery for failed cervical laminoplasty.
abstract: METHODS
  Retrospective analyses of six cases.
  
  
  OBJECTIVE
  To describe six patients with previous failed laminoplasty who were subsequently managed by anterior cervical decompression and fusion (ACDF) using fibular strut as revision surgeries.
  
  
  BACKGROUND
  While several complications and unsatisfactory results of cervical laminoplasty have been reported, there is no general consensus on how to best surgically treat these pathological conditions.
  
  
  METHODS
  Six patients, who had been treated by laminoplasty for cervical spondylotic myelopathy (n = 2) or ossification of posterior longitudinal ligament (OPLL, n = 4) and had unfavorable outcomes, underwent ACDF using autogenous fibular strut grafts. The pathological factors associated with the poor outcomes were intraforaminal spur, slip, spondylotic change, disc herniation, and increase of OPLL in size. Clinical outcomes were assessed by evaluating the modified Japanese Orthopedic Association score (JOA score) of cervical myelopathy, severity of radicular pains, axial pains, and perioperative complications. In addition, C2-7 angle and the presence of bony union were analyzed.
  
  
  RESULTS
  The revision ACDF significantly increased the mean ± SD. JOA score, from 10.3 ± 3.9 to 13.5 ± 2.7 points (p = 0.028), with a recovery rate of 47.1 ± 26.7%. Radicular pain and axial pain also improved. C2-7 angle was not changed significantly. Solid fusion was achieved in all patients at 12.2 ± 4.2 months after revision surgery.
  
  
  CONCLUSIONS
  ACDF with fibular strut graft was effective as a revision procedure for failed laminoplasty.
authors.affiliation: Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Komura
authors.forename: Kei
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Hideo
authors.initials: H
authors.lastname: Hosoe
authors.forename: Kazunari
authors.initials: K
authors.lastname: Fushimi
authors.forename: Chizuo
authors.initials: C
authors.lastname: Iwai
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nishimoto
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000000981:diagnostic imaging / Q000601:surgery; D010147:Pain Measurement; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome