title: Long-term clinical results of microsurgical transdural discectomy with laminoplasty: follow-up results over 10 years.
abstract: OBJECTIVE
  In this retrospective analysis the authors describe the long-term clinical results of microsurgical transdural discectomy with laminoplasty (MTDL) in patients with cervical disc herniation (CDH).
  
  
  METHODS
  Thirty patients (21 males, 9 females; mean age at surgery 55 years) with CDH had surgical treatments consisting of MTDL between 1990 and 1998. All patients demonstrated signs or symptoms of cervical myelopathy and/or radiculomyelopathy. Clinical outcomes were evaluated by the Japanese Orthopaedic Association (JOA) scoring system and by recovery rate (RR). The degenerative grades of the intervertebral discs were also evaluated based on preoperative, postoperative, and final follow-up MR images. The average follow-up period was 14.1 years (range 10-22 years).
  
  
  RESULTS
  Twenty (67%) of the 30 patients completed the follow-up in this study. The preoperative JOA scores in these patients averaged 11.8, and the postoperative scores at the final follow-up averaged 15.5 (average RR 69.6%). None of these patients required reoperation after MTDL. Although disc degeneration progressed during the follow-up period, there were no cases of clinical deterioration, recurrence of disc herniation, or postoperative kyphotic deformity.
  
  
  CONCLUSIONS
  Sufficient clinical results were obtained after the MTDL for a long-term follow-up period exceeding 10 years. The MTDL may be an option for an alternative procedure if the patients are correctly selected and the procedure is safely performed.
authors.affiliation: Department of Orthopaedic Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. nobut@hiroshima-u.ac.jp
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Sumida
authors.forename: Hideki
authors.initials: H
authors.lastname: Manabe
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Naosuke
authors.initials: N
authors.lastname: Kamei
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamae
authors.forename: Bunichiro
authors.initials: B
authors.lastname: Izumi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome