Combined expansive open-door laminoplasty with short-segment lateral mass instrumented fusion for multilevel cervical spondylotic myelopathy with short segment instability

Huan-Ming Tang^a, †, Kuang-Ting Yeh^{a, b}, †, Ru-Ping Lee^b, Ing-Ho Chen^{a, c}, Tzai-Chiu Yu^{a, c}, Kuan-Lin Liu^a, Cheng-Huan Peng^a, Jen-Hung Wang^d, Wen-Tien Wu^{a, b, c}

^a Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
^b Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
^c School of Medicine, Tzu Chi University, Hualien, Taiwan
^d Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan

Full-Text HTML |  Download PDF

Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract

Objectives

Expansive open-door laminoplasty (EOLP) is an effective procedure for multilevel cervical spondylotic myelopathy (MCSM). It preserves a higher range of cervical motion than laminectomy with fusion and reserves more posterior elements than laminectomy alone. MCSM with short-segment instability or correctable local kyphosis often requires long-segment decompression and adequate segment fusion.

Materials and Methods

We retrospectively reviewed 20 patients who received EOLP with short-segment posterior lateral mass instrumented fusion at our institution from 2008 to 2011. The follow-up period was at least 36 months. Postoperative functional and radiographic outcomes were collected and analyzed.

Results

Japanese Orthopedic Association scores improved significantly 36 months after surgery and the average recovery ratio was 85.3 ± 14.7%. Nurick disability scores and neck pain visual analog scale scores considerably decreased 3 years after surgery. No patients had aggravated neck pain or C5 nerve palsy during follow-up. The preservation of range of motion was approximately 60% after 36 months. No implant loosening or laminar collapse was reported on radiographic follow-up.

Conclusion

EOLP with concomitant lateral mass instrumented fusion yields favorable short-term clinical results for MCSM with short segment instability.

Keywords

Expansive open-door laminoplasty; Lateral mass instrumented fusion; Multilevel cervical spondylotic myelopathy; Short segment instability