J Korean Soc Spine Surg.  2010 Sep;17(3):147-153. 10.4184/jkss.2010.17.3.147.

Laminoplasty Versus Laminectomy and Fusion for Multilevel Cervical Spondylosis

• Lee CW
• Kang JH
• Lee KY
• Sung HW

• KMID: 1459280
• DOI: http://doi.org/10.4184/jkss.2010.17.3.147

Abstract

STUDY DESIGN: This is a retrospective study.
OBJECTIVES
We wanted to compare the clinical and radiographic outcomes of laminoplasty and laminectomy & fusion to treat multilevel cervical spondylosis. SUMMARY OF LITERATURE REVIEW: Laminoplasty and laminectomy & fusion are being increasingly used to treat multilevel cervical spondylosis, but definitive guidelines have not yet been established.
MATERIALS AND METHODS
Fifty eight patients who were followed up for more than a year and who were treated for multilevel cervical spondylosis with either laminoplasty or laminectomy & fusion between March 2000 and March 2009 were reviewed. Twenty eight patients who underwent laminectomy & fusion were matched with 30 patients who underwent laminoplasty.
RESULTS
The laminoplasty group showed statistically significant improvements in the Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) score. The cervical lordosis for the preoperative and latest sagittal alignment in the laminoplasty group decreased from 14 degrees to 5 degrees and the cervical kyphosis in the laminectomy & fusion group increased from 10 degrees to 15 degrees with no statistically significant difference. However, 3 cases with less than 5 degrees of cervical lordosis in the laminoplasty group showed progression of kyphosis at the last follow-up.
CONCLUSIONS
The clinical outcomes of laminoplasty for multilevel cervical spondylosis were better than those of laminectomy & fusion. However, it is considered that additional study for laminectomy & fusion is needed to prevent the long-term progress of cervical kyphosis in cases with preoperatively decreased cervical lordosis of less than 5 degrees, though it is impossible to make such comparisons with the small number of cases in our study.

Keyword

Cervical spondylosis; Laminoplasty; Laminectomy & fusion

MeSH Terms

Animals
Asian Continental Ancestry Group
Follow-Up Studies
Humans
Kyphosis
Laminectomy
Lordosis
Retrospective Studies
Spondylosis

Figure

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  Fig. 1 59-year-old woman with posterior decompression C3-4 & instrumented PLF for spinal stenosis C3-4, 4-5, 5-6 (A) Preoperative X-ray showing 8.9’ of cervical kyphosis (B) Postoperative X-ray showing 17.7’ of cervical kyphosis.

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