Neurologic Outcome of Laminoplasty for Acute Traumatic Spinal Cord Injury without Instability.
OBJECTIVE
The purpose of this study is to evaluate the efficacy of laminoplasty in the treatment of spinal cord injury (SCI) without instability.


METHODS
79 patients with SCI without instability who underwent surgical treatment in our institute between January 2005 and September 2012 were retrospectively reviewed. Twenty nine patients fulfilled the inclusion criteria as follows: SCI without instability, spinal cord contusion in MRI, cervical stenosis more than 20%, follow up at least 6 months. Preoperative neurological state, clinical outcome and neurological function was measured using the American Spinal Injury Association (ASIA) impairment scale, modified Japanese Orthopedic Association (mJOA) grading scale and Hirabayashi recovering rate.


RESULTS
Seventeen patients showed improvement in ASIA grade and twenty six patients showed improvement in mJOA scale at 6 month follow up. However, all patients with ASIA grade B and C have shown improvement of one or more ASIA grade. Mean Hirabayashi recovery rate was 47.4±23.7%. There was better neurologic recovery in those who had cervical spondylosis without ossification of posterior longitudinal ligament (OPLL) (p<0.05, χ(2) test).


CONCLUSIONS
It is different in B, C, D with ASIA A that there are debates going on about the application of surgical treatment in ASIA A, and surgical treatment is helpful in B, C, D since it contributes to neurologic improvement. We concluded that laminoplasty provided good neurologic recovery in SCI without instability that cervical canal stenosis, especially spondylosis without OPLL and neurologic deterioration in ASIA B, C and D.
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Hwa Joong
HJ
Lee
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Hwan Soo
HS
Kim
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Kyoung Hyup
KH
Nam
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
In Ho
IH
Han
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Won Ho
WH
Cho
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Byung Kwan
BK
Choi
Laminoplasty; Spinal cord injury; Surgical decompression