Surgical Results of en Bloc Open-door Laminoplasty.

Kim, Seok Won; Lee, Seung Meung; Shin, Ho; Kim, Hyun Sung

Original Article

Journal of Korean Neurosurgical Society 2005;38(2): 102-106.

Seok Won Kim, Seung Meung Lee, Ho Shin, Hyun Sung Kim

¹Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea. chosunns@hanmail.net
²Department of Neurosurgery, Mok-po Hankook Hospital, Mokpo, Korea.

ABSTRACT

OBJECTIVE
The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament(OPLL). METHODS: The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association(JOA) scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance image. RESULTS: In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, 87.43mm2 and in OPLL is 6.20mm, 117.61mm2. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity(preoperative JOA score), and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes.
CONCLUSION
Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

Key Words: En bloc open-door laminoplasty