Spondylotic Cervical Myelopathy; Clinical Results After Laminoplasty

Abstract

Background: To evaluate the clinical results in patients with cervical spondylotic myelopathy operated
surgically in our service by means of “open door” laminoplasty.
Methods: We performed a retrospective analysis of patients who underwent cervical spondylotic
myelopathy by laminoplasty between 2010 and 2017. Of the 102 patients operated on, we lost 18 cases or the
data were insufficient. Of the 84 cases, 56 male patients with an average age of 63 the following factors years
were evaluated: association of the lumbar pole, time between symptomatology and surgery, sagittal balance,
myelomalacia and clinical results using the Nurick scale and the modified JOA (Japanese Association of
Orthopedics).
Results: The most frequent area of laminoplasty was C3-C6 (70%). The preoperative JOA average was
10.6 and postoperative at 3 months of 14.5, obtaining a recovery rate using the Hirabayashi method of 61%.
The preoperative Nurick averaged 3.08 and at 3 months of 1.2. 42 patients presented with MRI hyperintense
signaling in T2. The recovery rate of JOA and Nurick was significantly higher in patients operated on less
than 6 months after symptom onset. We note a high incidence of bipolar suffering (30%). There were no major
complications, 2 presented transient paresis of C5, 1 patient presented seroma that required superficial drainage
and 4 presented mild axial pain that they did not have prior to surgery.
Conclusions: In our experience, open-door laminoplasty is a technique with very good clinical results and
a low incidence of complications for the treatment of cervical spondylotic myelopathy. We note a significant
association between the rate of recovery of the JOA and the period between symptoms and surgery. On the
other hand, we did not find a significant association between the clinical result and the number of spaces
released as well as the presence of marrow signal alterations