Cervical laminoplasty: description of the technique and bibliographic review

Abstract

Background: laminoplasty is a spinal cord decompression technique, through the enlargement of the spinal canal, with preservation of the posterior spinal elements.

Objectives: to present a case series of 80 patients treated with “open door” laminoplasties, to describe the surgical technique employed and to analyze the current literature.

Methods: 80 patients with multisegmented cervical canal narrowing that failed to respond to conservative measures underwent surgical treatment with “open door” laminoplasty between 2013-2019. We analyze demographic and intraoperative data; clinical outcomes were evaluated using the Nurick scale.

Results: 80 patients received surgical treatment with “open door” laminoplasty; 38 women and 42 men, between the ages of 43 and 83; 74 patients had surgery at 5 different cervical levels; the most frequent levels were C3-C7. The mean duration of surgery was 91 minutes; the average pre-operative and post-operative scores in the Nurick scale were Median = 3 (IQR 3-4) and Median = 1 (IQR 1-3) with a p <0.01; 4 patients required repeat operative intervention due to soft tissue infections, and 2 patients had loss of physiological cervical lordosis, progressing to kyphosis which required arthrodesis. The average length of stay (LOS) in days was 2.35.

Conclusion: laminoplasty is a valid surgical technique in the treatment of patients with cervical myelopathy, with low rates of post-operative kyphosis. The conservation of posterior muscle and ligamentous structures leads to decreased loss in range of motion (ROM) and less neck pain when compared with other surgical techniques.