title: Combined open door laminoplasty with unilateral screw fixation for unstable multi-level cervical stenosis : a preliminary report.
abstract: OBJECTIVE
  The authors reviewed their experiences of combined surgery (open door laminoplasty with unilateral screw fixation) for unstable multi-level cervical stenosis, to clarify the situation regarding the surgical approach most appropriate for the treatment of diffuse unstable multi-level cervical stenosis.
  
  
  METHODS
  From January 2011 to January 2012, combined surgery was performed for unstable multi-level cervical stenosis by one surgeon at our institution. The subjects of this study were 6 men of mean age 53.7 years (range, 48-71) with a mean follow-up of 9.3 (range, 3-14) months. All imaging studies showed severe multi-level cervical stenosis with spinal cord signal change, and instability or kyphotic deformity. A retrospective review of clinical, radiological, and surgical data was conducted.
  
  
  RESULTS
  Average laminoplasty level was 4.8 and the average screw fixation level was 5.0. Japanese Orthopedic Association score improved from an average of 5.2 to 11.2 points. According to Nurick's grades and Odom's criteria, symptom improvement was statistically significant. On the other hand, Cobb's angle changes were not significant. Average operation time was 5.86 hours with an average blood loss of 460 mL. No significant surgical complication was encountered.
  
  
  CONCLUSIONS
  Despite the small cohort and the short follow-up duration, the present study demonstrates that laminoplasty with unilateral screw fixation is a safe and effective treatment for unstable multi-level cervical stenosis.
authors.affiliation: Department of Neurosurgery, Gachon University, Gil Hospital, Incheon, Korea.
authors.forename: Seong
authors.initials: S
authors.lastname: Son
authors.forename: Sang Gu
authors.initials: SG
authors.lastname: Lee
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Park
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Kim
keywords: Japanese Orthopedic Association score; Laminoplasty; Lateral mass screw fixation
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