title: Comparative effectiveness of open-door laminoplasty versus French-door laminoplasty in cervical compressive myelopathy.
abstract: METHODS
  Prospective randomized study.
  
  
  OBJECTIVE
  This study aimed to prospectively compare the surgical results of the open- and French-door laminoplasty.
  
  
  BACKGROUND
  Cervical laminoplasty is a common surgical procedure for the treatment of cervical compressive myelopathy. These procedures are primarily classified as either open- or French-door laminoplasties. Only few prospective studies comparing the surgical results of the 2 procedures are available.
  
  
  METHODS
  A total of 92 patients with cervical compressive myelopathy who underwent cervical laminoplasty were prospectively enrolled and randomized into the following 2 groups according to the type of laminoplasty: open-door and French-door groups. A single attending spine surgeon performed all surgical procedures. The following factors were evaluated: surgical duration, blood loss, perioperative complications, neurological assessment using the Japanese Orthopedic Association score, and recovery rate. Radiological evaluations included assessment of the cervical lordotic angle and cervical range of motion. In addition, the ratio of postoperative spinal lamina opening was evaluated by magnetic resonance imaging.
  
  
  RESULTS
  There were no differences in perioperative complications and neurological outcomes between the 2 groups. The mean reduction in cervical lordotic angle after surgery was significantly greater in the open-door group than the French-door group (3.0° vs. 5.6°). Postoperative cervical range of motion significantly decreased in the open-door group than in the French-door group (19.3° vs. 26.0°). Postoperative cervical lordotic angle in the extension position significantly diminished in the open-door group than in the French-door group (7.9° vs. 14.1°). The ratio of opening of the spinal lamina after surgery was significantly larger in the open-door group than in the French-door group.
  
  
  CONCLUSIONS
  The 2 laminoplasty methods showed almost the same neurological recovery as well as perioperative complications. In cases of open-door laminoplasty, postoperative cervical alignment became more kyphotic and cervical range of motion was more restricted than that in French-door laminoplasty cases after surgery. French-door laminoplasty is preferable to open-door laminoplasty for postoperative cervical alignments.
  
  
  METHODS
  1.
authors: *Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; and †Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan.
authors: Hiroaki
authors: H
authors: Nakashima
authors: Fumihiko
authors: F
authors: Kato
authors: Yasutsugu
authors: Y
authors: Yukawa
authors: Shiro
authors: S
authors: Imagama
authors: Keigo
authors: K
authors: Ito
authors: Masaaki
authors: M
authors: Machino
authors: Naoki
authors: N
authors: Ishiguro
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D065406:Laminoplasty / Q000009:adverse effects / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome