Clinical Outcomes of En-Bloc Cervical Laminoplasty for Cervical Spondylitic Myelopathy

Abstract

Abstract Objective Cervical spondylotic myelopathy (CSM) is one of the most serious complications of cervical spondylosis. The pattern, timing and outcomes of surgical treatment are controversial. Hirabayashi's hardware-assisted open-door laminoplasty method is currently frequently used in the surgical treatment of CSM. It is important to establish the timing, technique and results of surgery.Materials and Methods This study analyzed the preoperative and postoperative outcomes of 32 patients who underwent en-bloc cervical laminoplasty for CSM. The effect of preop symptom duration on post op clinical outcomes and the clinical outcomes of the surgical technique applied were evaluated. Modified Japanese Orthopedic Associatin (mJOA) score and Nurick scale were used for preop and postop functional and neurologic evaluation.Results The mean age of the patients was 63 ± 2years. Twenty-one patients were male (65.6%) and 11 were female (34.3%) and the mean follow-up period was 33 ± 4 months. Three patients had one level, 6 had two levels, 10 had three levels, and 13 had four levels of spinal stenosis. 7 of 8 patients with mJOA scores of 15 and above had complete recovery and one had partial benefit. Of the 10 patients with mJOA scores between 12 and 15, 7 had improved above 15 points and 3 had showed partial improvement. Of the 14 patients with a score below 12, 10 had improved to the 12–15 range, while 3 had remained unchanged. Deterioration had observed in one patientConclusion It was found that low mJOA score, high Nurick grade and long preoperative symptom duration negatively affected the surgical treatment results.