Operative Results of Laminoplasty in Multilevel Cervical Spondylosis with Myelopathy: A Comparison of Two Surgical Techniques
Chanin Boontangjai MD*, Theerasan Keereratnikom MD*, Boonsin Tangtrakulwanich MD, PhD*
Affiliation : * Department of Orthopaedic Surgery and Physical Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective : To compare the surgical results of two unilateral open-door cervical laminoplasty in patients with multilevel
cervical spondylosis with myelopathy (CSM) or ossification of posterior longitudinal ligament (OPLL) in Songklanagarind
Hospital.
Material and Method: This was a cohort study between January 2007 and December 2009. Thirty-eight patients were
categorized into two groups of two periods. The Itoh and Tsuji laminoplasty technique (spinous process laminar elevation
spacer) was performed in the first group. In the second group, the modified Hirabayashi laminoplasty technique (secured
suture to elevated laminar with facet joint) was performed. All patients were followed up for at least 18 months. Demographic
data, physical examination, postoperative Nurick score, JOA score, and recovery rate were collected.
Results : All patients experienced improvement of neurological symptoms, Nurick score, JOA score, and recovery rate. There
were no postoperative complications such as C5 nerve root palsy or neck pain. There were no statistically significant
differences in all outcomes between the two surgical laminoplasty techniques. However, the modified Hirabayashi laminoplasty
technique had significantly less operative blood loss (p = 0.005) and a shorter operative time than the Itoh and Tsuji
technique.
Conclusion : There were no statistically significant differences in the surgical results of either technique, while the modified
Hirabayashi technique had less operative time and blood loss. This suggests that the modified Hirabayashi technique is the
technique of choice.
Keywords : Cervical spondylosis with myelopathy, Cervical laminoplasty
