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Instrumented open-door laminoplasty as treatment for cervical myelopathy in 104 patients.

Abstract
Treatment of multilevel cervical myelopathy remains a challenge. We report on a large series of cervical myelopathy patients treated with instrumented open-door laminoplasty. We retrospectively examined the medical records of 104 patients who had undergone instrumented open-door laminoplasty (titanium plate) for cervical myelopathy (minimum follow-up, 24 months). All patients had been myelopathic, 57 (54.8%) had stenosis, 39 (37.5%) had spondylosis, 66 (63.5%) reported gait disturbance, 18 (17.3%) had handwriting changes, 33 (31.7%) complained of deterioration of dexterity, 56 (53.8%) had grasp weakness, 7 (6.7%) had bowel and bladder complaints, 27 (26.0%) had a positive Hoffmann sign, 10 (9.6%) had sustained clonus, and 10 (9.6%) had a positive Babinski sign. Mean preoperative-to-postoperative improvement in Nurick grade was 1.47. Complications included 4 nerve root injuries (3.8%), 1 of which (at C5) was permanent, and 1 transient neurologic deterioration (<1%), 1 incidental durotomy (<1%), and 5 wound infections (4.8%). Four patients required anterior revision for persistent symptoms. Open-door laminoplasty with miniplate instrumentation is an effective, safe method for preventing progression of myelopathy with multilevel involvement while alleviating the need for multilevel fusion.
AuthorsJohn R Dimar 2nd, Kelly R Bratcher, Dylan C Brock, Steven D Glassman, Mitchell J Campbell, Leah Y Carreon
JournalAmerican journal of orthopedics (Belle Mead, N.J.) (Am J Orthop (Belle Mead NJ)) Vol. 38 Issue 7 Pg. E123-8 (Jul 2009) ISSN: 1934-3418 [Electronic] United States
PMID19714281 (Publication Type: Journal Article)
Topics
  • Cervical Vertebrae (surgery)
  • Decompression, Surgical (adverse effects, methods)
  • Female
  • Humans
  • Laminectomy (adverse effects, methods)
  • Male
  • Middle Aged
  • Neck
  • Postoperative Complications (etiology)
  • Retrospective Studies
  • Spinal Cord Compression (physiopathology, surgery)
  • Spinal Cord Diseases (physiopathology, surgery)
  • Spinal Stenosis (physiopathology, surgery)
  • Treatment Outcome

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