Advance Access: Clinical Outcomes of Cervical Laminoplasty: Results at Two Years

BACKGROUND: Laminoplasty is an established treatment for cervical myelopathy. Multiple variations have emerged, many advocating the use of allograft, but controversy persists.
OBJECTIVE: To assess medium-term clinical outcomes in patients who underwent laminoplasty with autograft at our institution.
METHODS: Thirty-two consecutive patients (19 male, 13 female, average age 66 yr) from our prospective outcome registry that underwent cervical laminoplasty between 2009 and 2013 were reviewed. Computed tomography (CT) scan was performed immediately postoperatively and at 6-mo follow-up. Parameters included patient perception of outcome, Nurick score, Neck Disability Index (NDI), visual analog scale for neck pain, and SF-36.
RESULTS: On retrospective analysis, all patients felt improved at 3 mo postoperatively; at 2 yr, this rate was 91%. Improvements were seen in Nurick scores, from 3.16 ± 0.9 preoperatively to 1.94 ± 0.8 at 2 yr; NDI score from 28.7% ± 9% preoperatively to 20.8% ± 9.6% at 2 yr; visual analog scale from 2.8 ± 1.2 preoperatively to 1.7 ± 0.9 at 2 yr; and SF-36 physical component summary from 27.9 ± 10 preoperatively to 37.8 ± 11.9 at 2 yr. All values reached significance at all follow-up points (P < .05) with the exception of 6-mo NDI values (P = .062). No C5 palsy, graft complications, or reclosure was observed in any patient during the follow-up period.
CONCLUSION: Laminoplasty with autograft is a safe and effective method to treat cervical myelopathy, with good medium-term clinical outcome. No reclosures were observed. Bony fusion was seen in all cases on CT scan. Our study found good outcomes in the performance of open-door laminoplasty without hardware, in the treatment of cervical stenosis.

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