title: A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results.
abstract: The laminoplasty technique was devised by Hirabayashi in 1978 for patients diagnosed with multilevel cervical spondylotic myelopathy.
  
  
  OBJECTIVE
  To describe an easy modification of Hirabayashi's method and present the clinical and radiological results from a five-year follow-up study.
  
  
  RESULTS
  Eighty patients had 5 levels of decompression (C3-C7), 3 patients had 6 levels of decompression (C2-T1) and 3 patients had 4 levels of decompression (C3-C6). Foraminotomies were performed in 23 cases (27%). Following Nurick`s scale, 76 patients (88%) improved, 9 (11%) had the same Nurick grade, and one patient worsened and was advised to undergo another surgical procedure. No deaths were observed. The mean surgery time was 122 min. Radiographic evaluation showed an increase in the mean sagittal diameter from 11.2 mm at pretreatment to 17.3 mm post surgery. There was no significant difference between pretreatment and post-surgery C2-C7 angles.
  
  
  CONCLUSIONS
  This two-open-doors laminoplasty technique is safe, easy and effective and can be used as an alternative treatment for cases of multilevel cervical spondylotic myelopathy without instability.
authors.affiliation: Department of Neurosurgery, Clinical Hospital, Federal University of Minas Gerais, Belo HorizonteMG, Brazil.
authors.forename: Aluizio Augusto
authors.initials: AA
authors.lastname: Arantes Júnior
authors.affiliation: Department of Neurosurgery, Clinical Hospital, Federal University of Minas Gerais, Belo HorizonteMG, Brazil.
authors.forename: Geraldo Alves da
authors.initials: GA
authors.lastname: Silva Junior
authors.affiliation: Department of Neurosurgery, Clinical Hospital, Federal University of Minas Gerais, Belo HorizonteMG, Brazil.
authors.forename: José Augusto
authors.initials: JA
authors.lastname: Malheiros
authors.forename: Fernando Flavio
authors.initials: FF
authors.lastname: Gonçalves
authors.affiliation: Department of Neurosurgery, Clinical Hospital, Federal University of Minas Gerais, Belo HorizonteMG, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Magaldi
authors.affiliation: Federal University of Minas Gerais, School of Medicine, Belo HorizonteMG, Brazil.
authors.forename: Erica
authors.initials: E
authors.lastname: Santiago
authors.affiliation: Federal University of Minas Gerais, School of Medicine, Belo HorizonteMG, Brazil.
authors.forename: Arthur Adolfo
authors.initials: AA
authors.lastname: Nicolato
authors.affiliation: Department of Neurosurgery, Clinical Hospital, Federal University of Minas Gerais, Belo HorizonteMG, Brazil.
authors.forename: Sebastião Nataniel Silva
authors.initials: SN
authors.lastname: Gusmão
mesh_terms: D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome