Selective Laminoplasty For Cervical Myelopathy: 3 Cases Report.
10.4184/jkss.2012.19.3.116
- Author:
Dhong Won LEE
1
;
Jeong Gook SE
Author Information
1. Department of Orthopedic Surgery, Inje University, Seoul Paik Hospital, Seoul, Korea. hd1404@hanafos.com
- Publication Type:Case Report
- Keywords:
Cervical myelopathy;
Selective laminoplasty
- MeSH:
Asian Continental Ancestry Group;
Constriction, Pathologic;
Decompression;
Dura Mater;
Humans;
Ligaments;
Magnetic Resonance Imaging;
Muscles;
Operative Time;
Orthopedics;
Paresis;
Range of Motion, Articular;
Spinal Cord;
Spinal Cord Diseases
- From:Journal of Korean Society of Spine Surgery
2012;19(3):116-121
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: 3 cases report. OBJECTIVES: We present 3 cases of cervical myelopathy treated successfully by selective laminoplasty on 2 levels or less, using Kurokawa technique with a review of the relevant articles. SUMMARY OF LITERATURE REVIEW: As there were no clear criteria for the numbers of the laminae that require decompression in a standard laminoplasty, a wide level laminoplasty from C3 to C7 has been generally done. As a result, complications such as axial pain, C5 root paresis, and loss of range of motion have been reported commonly. To reduce these complications, recent studies have attempted less invasive procedures, such as selective laminoplasty or preservation of posterior ligament and muscle components. MATERIALS AND METHODS: There were two cases of developmental stenosis and one posterior compressive stenosis that underwent selective laminoplasty. The posterior shift of the spinal cord and the dural expansion were measured by magnetic resonance imaging at 3 or 4 weeks after surgery. Clinical outcomes were evaluated by Japanese Orthopedic Association (JOA) score. Axial pain was classified as follows; never: Grade 0; mild: Grade 1; moderate: Grade 2; and severe: Grade 4. RESULTS: The spinal cord had a tendency to shift posterioly and the dura mater was expanded in all cases. Clinical outcomes and axial pain were also improved in all. CONCLUSIONS: Selective laminoplasty that enabled the surgeon to perform a less invasive surgery preserving operative time and the patient to have a lower risk of C5 root paresis is effective for the developmental stenosis or posterior compressive stenosis less than 3 levels.
