title: Comparison of Functional and Radiological Outcomes Between Two Posterior Approaches in the Treatment of Multilevel Cervical Spondylotic Myelopathy.
abstract: BACKGROUND
  Posterior cervical decompression is an accepted treatment for multilevel cervical spondylotic myelopathy (CSM). Each posterior technique has its own advantages and disadvantages. In the present study, we compared the functional and radiological outcomes of expansive hemilaminectomy and laminoplasty with mini titanium plate in the treatment of multilevel CSM.
  
  
  METHODS
  Forty-four patients with multilevel CSM treated with posterior cervical surgery in Department of Orthopedic Surgery, Beijing Army General Hospital from March 2011 to June 2012 were enrolled in this retrospective study. Patients were divided into two groups by surgical procedure: Laminoplasty (Group L) and hemilaminectomy (Group H). Perioperative parameters including age, sex, duration of symptoms, operative duration, and intraoperative blood loss were recorded and compared. Spinal canal area, calculated using AutoCAD ® software(Autodesk Inc., San Rafael, CA, USA), and neurological improvement, evaluated with Japanese Orthopedic Association score, were also compared.
  
  
  RESULTS
  Neurological improvement did not differ significantly between groups. Group H had a significantly shorter operative duration and significantly less blood loss. Mean expansion ratio was significantly greater in Group L (77.83 ± 6.41%) than in Group H (62.72 ± 3.86%) (P < 0.01).
  
  
  CONCLUSIONS
  Both surgical approaches are safe and effective in treating multilevel CSM. Laminoplasty provides a greater degree of enlargement of the spinal canal, whereas expansive hemilaminectomy has the advantages of shorter operative duration and less intraoperative blood loss.
authors.forename: Da-Jiang
authors.initials: DJ
authors.lastname: Ren
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.forename: Zhi-Cheng
authors.initials: ZC
authors.lastname: Zhang
authors.forename: Guan
authors.initials: G
authors.lastname: Kai
authors.forename: Jian-Lin
authors.initials: JL
authors.lastname: Shan
authors.forename: Guang-Min
authors.initials: GM
authors.lastname: Zhao
authors.affiliation: Department of Orthopedic Surgery, Beijing Army General Hospital, Beijing 100700, China.
authors.forename: Tian-Sheng
authors.initials: TS
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000473:pathology* / Q000601:surgery*