title: Modified expansive open-door laminoplasty technique improved postoperative neck pain and cervical range of motion.
abstract: OBJECTIVE
  Expansive open-door laminoplasty (EOLP) is a useful technique for multiple-level cervical spondylotic myelopathy. The common postoperative complications of EOLP include moderate to severe neck pain, loss of cervical lordosis, decrease of cervical range of motion, and C5 palsy. We modified the surgical technique to lessen these complications. This study is aimed to elucidate the efficacy of modified techniques to lessen the complications of traditional procedures.
  
  
  METHODS
  We collected data from 126 consecutive patients treated at our institution between August 2008 and December 2012. Of these, 66 patients underwent conventional EOLP (CEOLP) and the other 60 patients underwent modified EOLP (MEOLP). The demographic and preoperative data, axial pain visual analog scale scores at 2 weeks and 3 months postoperatively, clinical outcomes evaluated using Nurick score and Japanese Orthopedic Association recovery rate at 12 months postoperatively, and radiographic results assessed using plain films at 3 months and 12 months postoperatively for both groups were compared and analyzed.
  
  
  RESULTS
  There were no significant differences regarding the preoperative condition between the CEOLP and MEOLP groups (p > 0.05). The Japanese Orthopedic Association recovery rate of the MEOLP group was 70.3%, comparable to the result of the other group (70.2%). Postoperative axial neck pain, loss of range of motion, and loss of lordosis of cervical curvature decreased significantly in the MEOLP group (p < 0.05). The complications of temporary C5 nerve palsy found in the CEOLP group did not exist in the MEOLP group.
  
  
  CONCLUSIONS
  MEOLP is a minimally invasive surgical method to treat multiple-level cervical spondylotic myelopathy, which decreases postoperative complications effectively.
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors.forename: Kuang-Ting
authors.initials: KT
authors.lastname: Yeh
authors.affiliation: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Ing-Ho
authors.initials: IH
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Tzai-Chiu
authors.initials: TC
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors.forename: Kuan-Lin
authors.initials: KL
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors.forename: Cheng-Huan
authors.initials: CH
authors.lastname: Peng
authors.affiliation: Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
authors.forename: Jen-Hung
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
authors.forename: Ru-Ping
authors.initials: RP
authors.lastname: Lee
authors.affiliation: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: wentien2003@yahoo.com.tw.
authors.forename: Wen-Tien
authors.initials: WT
authors.lastname: Wu
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D065406:Laminoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D019547:Neck Pain / Q000517:prevention & control; D010149:Postoperative Pain; D010243:Paralysis / Q000517:prevention & control; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013128:Spinal Osteophytosis / Q000601:surgery*; D013624:Taiwan; D016896:Treatment Outcome
keywords: C5 palsy; minimally invasive surgical method; modified expansive open-door laminoplasty; multiple-level cervical spondylotic myelopathy; postoperative axial neck pain