The purpose of this study was to compare modified plate-only
laminoplasty and
laminectomy and fusion to confirm which of the 2 surgical modalities could achieve a better
decompression outcome and whether a significant difference was found in postoperative complications. Clinical data were retrospectively reviewed for 141 patients with cervical stenotic
myelopathy who underwent plate-only
laminoplasty and
laminectomy and fusion between November 2007 and June 2010. The extent of
decompression was assessed by measuring the cross-sectional area of the dural sac and the distance of spinal cord drift at the 3 most narrowed levels on T2-weighted magnetic resonance imaging. Clinical outcomes and complications were also recorded and compared. Significant enlargement of the dural sac area and spinal cord drift was achieved and well maintained in both groups, but the extent of
decompression was greater in patients who underwent
laminectomy and fusion; however, a greater
decompression did not seem to produce a better clinical outcome. No significant difference was observed in Japanese Orthopaedic Association and Nurick scores between the 2 groups. Patients who underwent plate-only
laminoplasty showed a better improvement in Neck Dysfunction Index and visual analog scale scores. In addition, limited
decompression, rigid reconstruction of the spinal canal, and preservation of cervical mobility combined with preservation of the posterior structure resulted in a lower rate of postoperative C5
palsy and axial
pain in the modified
laminoplasty group. For this reason, modified
laminoplasty may be a more viable option for patients with cervical stenotic
myelopathy.