Abstract
Introduction
In this study, we compared modified plate-only laminoplasty with laminotomy and fusion to confirm which of the two surgical modalities could achieve a better decompression outcome, and whether there was any significant difference in postoperative complications between the two techniques.
Materials and Methods
Clinical data of 141 patients with cervical stenotic myelopathy who underwent plate-only laminoplasty and laminectomy from November 2007 to June 2010 were reviewed retrospectively. The extent of decompression was assessed by measuring the cross-sectional area of the dural sac and the distance of spinal cord drift at 3 most narrowed levels on T2-weighed MRI. Clinical outcomes and complications were also recorded and compared.
Results
Significant enlargement of dural sac area and spinal cord drift was achieved and well maintained in both groups, while the extent of decompression was greater in patients who underwent laminectomy and fusion. However, a greater decompression extent did not seem to produce a better clinical outcome. No significant difference was observed in JOA scores and Nurick scores between the two groups. Patients who underwent plate-only laminoplasty showed a better improvement in NDI scores and VAS scores. In addition, limited decompression, rigid reconstruction of the spinal canal, preservation of cervical mobility together with preservation of the posterior structure resulted in a lower rate of postoperative C5 palsy and axial pain in modified laminoplasty group.
Conclusion
Modified laminoplasty may be a more viable option for patients with cervical stenotic myelopathy.
None declared