• J Spinal Disord Tech · May 2013

    Modified double-door laminoplasty in managing multilevel cervical spondylotic myelopathy: surgical outcome in 520 patients and technique description.

    • Masaaki Machino, Yasutsugu Yukawa, Tetsuro Hida, Keigo Ito, Hiroaki Nakashima, Shunsuke Kanbara, Daigo Morita, and Fumihiko Kato.
    • Department of Orthopedic Surgery, Chubu Rosai Hospital, Japan Labor Health and Welfare Organization, Aichi, Japan. masaaki_machino_5445_2@yahoo.co.jp
    • J Spinal Disord Tech. 2013 May 1;26(3):135-40.

    Study DesignThis is a prospective study on surgical outcomes of double-door laminoplasty in patients with cervical spondylotic myelopathy (CSM).ObjectiveThe purpose of this study was to report the efficacy and safety of modified double-door laminoplasty in a large series of patients with CSM.Summary Of Background DataLaminoplasty is an established procedure for the decompression of multisegmental CSM. However, no report has described the clinical outcomes of laminoplasty for a large number of patients with CSM (>500 patients).MethodsBetween April 1995 and December 2006, 520 consecutive patients (331 male and 189 female) with CSM who underwent double-door laminoplasty and were followed-up for more than 1 year were enrolled in this study. The mean age was 62.2 years (23 to 93 y), and the mean duration of disease was 20.1 ± 32.0 months. The severity of myelopathy before and after surgery was evaluated according to a scoring system proposed by the Japanese Orthopedic Association for cervical myelopathy (JOA score). Functional improvement was expressed by the recovery rate (RR) of the JOA score.ResultsThe average surgery time for laminoplasty was 75.2 ± 23.3 minutes, and the average blood loss was 72.6 ± 84.6 mL. The average follow-up period was 33.3 ± 15.7 months. The mean JOA score was 10.4 ± 2.8 points preoperatively and 13.6 ± 2.5 points at final follow-up. The mean RR was 51.2 ± 2 9.0%. On the basis of RR, we found that the conditions of 493 patients (94.8%) improved (RR, >1%), 20 patients (3.8%) showed no change (RR, 0%), and 7 patients (1.3%) in worse condition (RR, < 0%). The 7 patients deteriorated for reasons (lumbar spinal canal stenosis and cerebral infarction) that were unrelated to CSM.ConclusionsModified double-door laminoplasty is a safe, reliable, and effective procedure for patients with CSM.

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