• Xin-yu Liu, Suo-mao Yuan, Yong-hao Tian, Yan-ping Zheng, and Jian-min Li.
• Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, China. newyuliu@yahoo.com.cn
• Orthop Surg. 2011 Aug 1;3(3):161-6.

ObjectiveTo evaluate the clinical results of combined expansive open-door laminoplasty by splitting of spinous processes and selective anterior cervical decompression and fusion in treatment of multilevel severe cervical spondylotic myelopathy (CSM).MethodsTwenty-eight patients (16 men and 12 women) underwent one-stage combined expansive open-door laminoplasty and selective anterior decompression and fusion for severe CSM; the average patient age was 51.3 years (range, 32-63 years). Clinical results were assessed by Japanese Orthopaedic Association (JOA) scores, number of finger grip and releases (G and R) in ten seconds, hand-grip strength, visual analog scale (VAS) of axial pain, and C2-C7 angle.Results  There was no worsening of neurological symptoms due to cord injury, cerebrospinal fluid leakage, or wound infection. All cases completed one-year follow-up. The JOA scores, number of G and R in ten seconds, and hand-grip strength were all significantly improved (P < 0.05). Satisfactory decompression was shown by MRI or CT to have been achieved in all cases. The C2-C7 angle did not differ significantly from that found pre-operatively. The axial neck pain score was 2.0 ± 0.1 on VAS.ConclusionCombined expansive open-door laminoplasty by splitting of spinous processes and selective anterior decompression and fusion achieves complete spinal canal decompression with minimal morbidity; this strategy is effective in improving the surgical outcomes of CSM in one-year follow-up.© 2011 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

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