Posterior cervical laminoplasty in the North American Population: A minimum of two year follow-up.
BACKGROUND
The efficacy of expansile cervical laminoplasty for cervical spondylotic myelopathy has been validated in the literature. To date, however, the majority of large, long-term data in the literature have originated in Japan. Few studies have originated from North America that include follow up greater than one year, and none of these includes a single surgeon's experience. This paper presents the retrospective results of a single surgeon with an average follow up of 47 months in a large population of North American patients.


METHODS
A single surgeon's series of 80 consecutive patients who underwent expansile open-door laminoplasty for cervical myelopathy was reviewed. The severity of disability was graded using the Nurick Functional Disability Score and the Miami Upper Extremity Function (MUEF) score. Patients were evaluated preoperatively, six months postoperatively, and at a minimum of 24 months postoperatively. All examinations were performed by a single physician. MRI scans of the cervical spine were obtained at four months postoperatively in all patients. Radiographs were used to evaluate postoperative lordosis.


RESULTS
Average length of follow up was 47 months. Nurick scores improved from an average of 2.3 preoperatively to postoperative scores of 1.5 (p>.05) at six months and 1.4 (p>.05) at two years. MUEF scores also improved at both the six month and two year intervals. All patients had improved canal diameter on post-operative MRI scan evaluation obtained four months post-operatively.


CONCLUSIONS
This study confirms that laminoplasty is a safe and effective treatment of cervical spondylotic myelopathy in the North American population.


METHODS
Case Series Level IV.
Department of Orthopaedic Surgery, University of California, Irvine Medical Center, 101 The City Drive South, Pavilion III, Orange, CA 92868, United States. Electronic address: bhatian@uci.edu.
Nitin N
NN
Bhatia
Department of Orthopaedic Surgery, University of California, Irvine Medical Center, 101 The City Drive South, Pavilion III, Orange, CA 92868, United States. Electronic address: gregl@uci.edu.
Gregory
G
Lopez
Seton Spine and Scoliosis Center, 1600 West 38th Street, Suite 200, Austin, TX 78731, United States. Electronic address: mattgeck@mac.com.
Matthew
M
Geck
Department of Orthopaedics, University of Miami Miller School of Medicine, 1400 NW 12th Ave, West Building, Suite #306, Miami, FL 33136, United States. Electronic address: jgottlieb@med.miami.edu.
Jonathan
J
Gottlieb
Department of Orthopaedics, University of Miami Miller School of Medicine, P.O. Box 016960 (D-27), Miami, FL 33101, United States. Electronic address: feismont@med.miami.edu.
Frank
F
Eismont
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D065406:Laminoplasty / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D009656:North America; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D013130:Spinal Stenosis / Q000601:surgery*; D055009:Spondylosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Cervical laminoplasty; Cervical spondylosis; Expansile cervical laminoplasty