Development and Achievement of Cervical Laminoplasty and Related Studies on Cervical Myelopathy

Abstract OPEN-DOOR EXPANSILE laminoplasty is a practical surgical technique for the treatment of cervical myelopathy secondary to cervical spinal stenosis. Laminoplasty procedures were first described in the late 1970s and have undergone numerous modifications. The current article reviews the indications, techniques, and outcome data for cervical laminoplasty. Complications of laminoplasty and comparison to laminectomy outcomes are also discussed.

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21. The safety and efficacy of cervical laminectomy and fusion vs cervical laminoplasty surgery in degenerative cervical myelopathy: a prospective randomized trial

The Spine Journal ◽

10.1016/j.spinee.2020.05.124 ◽

2020 ◽

Vol 20 (9) ◽

pp. S11

Author(s):

Haitham Kandel ◽

Mohamed Soliman ◽

Mohamed ElMallawany ◽

Tarek Tareef ◽

Ahmed Elsaid ◽

...

Keyword(s):

Randomized Trial ◽

Cervical Myelopathy ◽

Prospective Randomized Trial ◽

Cervical Laminoplasty ◽

Safety And Efficacy ◽

Cervical Laminectomy ◽

Laminectomy And Fusion ◽

Degenerative Cervical Myelopathy

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Achondroplasia and cervical laminoplasty

Journal of Neurosurgery Spine ◽

10.3171/2009.4.spine09164 ◽

2009 ◽

Vol 11 (4) ◽

pp. 417-420 ◽

Cited By ~ 4

Author(s):

June Yoshii ◽

Vincent C. Traynelis

Keyword(s):

Surgical Treatment ◽

Cervical Myelopathy ◽

Spinal Canal ◽

Spinal Canal Stenosis ◽

Adult Woman ◽

Segmental Motion ◽

Cervical Laminoplasty ◽

Canal Stenosis

Achondroplasia is associated with short pedicles that predispose individuals with this trait to develop symptomatic spinal canal stenosis. Laminoplasty is an excellent means of treating cervical myelopathy due to stenosis in selected individuals. Laminoplasty preserves segmental motion and stability, both of which are of benefit to all individuals. The authors report the successful surgical treatment of an achondroplastic adult woman with laminoplasty. This procedure alleviated her symptoms, and she was doing well at 2-year follow-up.

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Open-door Cervical Expansile Laminoplasty

Neurosurgery ◽

10.1227/01.neu.0000097513.91248.26 ◽

2004 ◽

Vol 54 (1) ◽

pp. 119-124 ◽

Cited By ~ 21

Author(s):

Michael Y. Wang ◽

Barth A. Green

Keyword(s):

Cervical Myelopathy ◽

Cervical Spondylotic Myelopathy ◽

Cervical Laminoplasty ◽

Open Door ◽

Extensive Experience ◽

Canal Stenosis

Abstract CERVICAL LAMINOPLASTY IS becoming a popular technique for the treatment of cervical myelopathy that is the result of multilevel canal stenosis. Many variations in this technique, which was originally created in Japan, have been developed, all with the goal of increasing canal space and reconstructing the posterior bony arch. We describe our extensive experience with this procedure for the treatment of cervical spondylotic myelopathy.

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Relationship Between C2 Semispinalis Cervicis Preservation and C2 Spinous Process Morphology During Cervical Laminoplasty Involving C3

Global Spine Journal ◽

10.1177/21925682211062496 ◽

2021 ◽

pp. 219256822110624

Author(s):

Sang Yun Seok ◽

Dong-Ho Lee ◽

Hyung Rae Lee ◽

Sehan Park ◽

Jae Hwan Cho ◽

...

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Neck Pain ◽

Clinical Outcomes ◽

Cervical Myelopathy ◽

Spinous Process ◽

Three Dimensional ◽

Anatomical Variations ◽

Cervical Laminoplasty ◽

The Relationship

Study Design Retrospective study Objectives Due to anatomical variations in the semispinalis cervicis insertion in the C2 spinous process, complete preservation is not always possible when the C3 level is included in a cervical laminoplasty. Three-dimensional computed tomography was used to evaluate the relationship between the incidence of semispinalis cervicis injury and the C2 inter-spinous angle. Methods We included 95 patients who underwent a cervical laminoplasty that included a C3 laminectomy for cervical myelopathy. Patients with a C2 inter-spinous angle above and below 60° were classified into wide- and narrow-angled groups, respectively (n = 48 and n = 47). Whether the C2 semispinalis cervicis insertion was preserved, or detached and reattached was reviewed from surgical records. The pre and postoperative C2-C7 lordosis and range of motion (ROM) were measured, and clinical outcomes were obtained from the patient charts. Results The C2 semispinalis cervicis was preserved in 47 patients (97.9%) in the wide-angled group but only in 14 patients (29.8%) in the narrow-angled group ( P < .001). The postoperative C2-C7 lordosis extension and ROM were significantly greater in the wide-angled ( P = .048 and .036). Postoperative neck pain was significantly greater in the narrow-angled ( P = .018). Conclusions The morphology of the C2 spinous process indicates that a C2 semispinalis cervicis insertion preservation is possible during a cervical laminoplasty that includes a C3 laminectomy. A careful surgical procedure should be conducted when the C2 inter-spinous angle is above 60° to increase the likelihood of achieving this preservation and thereby obtaining a more favorable clinical outcomes.

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Intra- and Post-Complications of Cervical Laminoplasty for the Treatment of Cervical Myelopathy

Spine ◽

10.1097/brs.0000000000003574 ◽

2020 ◽

Vol 45 (20) ◽

pp. E1302-E1311

Author(s):

Mohamed Kamal Mesregah ◽

Ian A. Buchanan ◽

Blake Formanek ◽

Jeffrey C. Wang ◽

Zorica Buser

Keyword(s):

Cervical Myelopathy ◽

Cervical Laminoplasty

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Clinical Outcomes of Cervical Laminoplasty: Results at Two Years

Neurosurgery ◽

10.1093/neuros/nyw058 ◽

2016 ◽

Vol 80 (6) ◽

pp. 934-941 ◽

Cited By ~ 4

Author(s):

Melissa M. Stamates ◽

Michael X. Cui ◽

Ben Z. Roitberg

Keyword(s):

Ct Scan ◽

Clinical Outcomes ◽

Visual Analog Scale ◽

Cervical Myelopathy ◽

Neck Disability Index ◽

Cervical Laminoplasty ◽

Medium Term ◽

Analog Scale ◽

Sf 36

Abstract BACKGROUND: Laminoplasty is an established treatment for cervical myelopathy. Multiple variations have emerged, many advocating the use of allograft, but controversy persists. OBJECTIVE: To assess medium-term clinical outcomes in patients who underwent laminoplasty with autograft at our institution. METHODS: Thirty-two consecutive patients (19 male, 13 female, average age 66 yr) from our prospective outcome registry that underwent cervical laminoplasty between 2009 and 2013 were reviewed. Computed tomography (CT) scan was performed immediately postoperatively and at 6-mo follow-up. Parameters included patient perception of outcome, Nurick score, Neck Disability Index (NDI), visual analog scale for neck pain, and SF-36. RESULTS: On retrospective analysis, all patients felt improved at 3 mo postoperatively; at 2 yr, this rate was 91%. Improvements were seen in Nurick scores, from 3.16 ± 0.9 preoperatively to 1.94 ± 0.8 at 2 yr; NDI score from 28.7% ± 9% preoperatively to 20.8% ± 9.6% at 2 yr; visual analog scale from 2.8 ± 1.2 preoperatively to 1.7 ± 0.9 at 2 yr; and SF-36 physical component summary from 27.9 ± 10 preoperatively to 37.8 ± 11.9 at 2 yr. All values reached significance at all follow-up points (P < .05) with the exception of 6-mo NDI values (P = .062). No C5 palsy, graft complications, or reclosure was observed in any patient during the follow-up period. CONCLUSION: Laminoplasty with autograft is a safe and effective method to treat cervical myelopathy, with good medium-term clinical outcome. No reclosures were observed. Bony fusion was seen in all cases on CT scan. Our study found good outcomes in the performance of open-door laminoplasty without hardware, in the treatment of cervical stenosis.

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A Prospective, Randomized Trial Comparing Expansile Cervical Laminoplasty and Cervical Laminectomy and Fusion for Multilevel Cervical Myelopathy

Neurosurgery ◽

10.1227/neu.0b013e3182305669 ◽

2011 ◽

Vol 70 (2) ◽

pp. 264-277 ◽

Cited By ~ 84

Author(s):

Glen R. Manzano ◽

Gizelda Casella ◽

Michael Y. Wang ◽

Steven Vanni ◽

Allan D. Levi

Keyword(s):

Range Of Motion ◽

Cervical Myelopathy ◽

Cervical Spondylotic Myelopathy ◽

Cervical Laminoplasty ◽

Japanese Orthopedic Association Score ◽

Association Score ◽

Japanese Orthopedic Association ◽

Canal Area ◽

Cervical Laminectomy ◽

Laminectomy And Fusion

Abstract BACKGROUND: Controversy exists as to the best posterior operative procedure to treat multilevel compressive cervical spondylotic myelopathy. OBJECTIVE: To determine clinical, radiological, and patient satisfaction outcomes between expansile cervical laminoplasty (ECL) and cervical laminectomy and fusion (CLF). METHODS: We performed a prospective, randomized study of ECL vs CLF in patients suffering from cervical spondylotic myelopathy. End points included the Short Form-36, Neck Disability Index, Visual Analog Scale, modified Japanese Orthopedic Association score, Nurick score, and radiographic measures. RESULTS: A survey of academic North American spine surgeons (n = 30) demonstrated that CLF is the most commonly used (70%) posterior procedure to treat multilevel spondylotic cervical myelopathy. A total of 16 patients were randomized: 7 to CLF and 9 to ECL. Both groups showed improvements in their Nurick grade and Japanese Orthopedic Association score postoperatively, but only the improvement in the Nurick grade for the ECL group was statistically significant (P < .05). The cervical range of motion between C2 and C7 was reduced by 75% in the CLF group and by only 20% in the ECL group in a comparison of preoperative and postoperative range of motion. The overall increase in canal area was significantly (P < .001) greater in the CLF group, but there was a suggestion that the adjacent level was more narrowed in the CLF group in as little as 1 year postoperatively. CONCLUSION: In many respects, ECL compares favorably to CLF. Although the patient numbers were small, there were significant improvements in pain measures in the ECL group while still maintaining range of motion. Restoration of spinal canal area was superior in the CLF group.

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