Operative results of laminoplasty in multilevel cervical spondylosis with myelopathy: a comparison of two surgical techniques.

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.