1995 Volume 4 Issue 2 Pages 151-156
The results of an expansive laminoplasty with a unilateral opening have been evaluated in 25 patients with cervical spondylotic myelopathy caused by a narrowed canal and/or multisegmental spondylosis. At one year postoperatively, drilled and hinged laminae showed sufficient bony consolidation for stabilizing the posterior spinal structure in all patients. However, in 3 patients the laminae were inadvertently separated from the lateral mass of the vertebrae during their hinging and had dislocated into the spinal column. Even so, this dislocation had no adverse effect on the patients' neurological conditions and six months after the laminoplasty, a spontaneous reduction was noted with a definite bony fusion. Further, at six months postoperatively, a slightly kyphotic deformity occurred in 2 patients, but no further deformity developed in these patients and the spinal column remained unchanged and no neurological dysfunctions that could be ascribed to this deformity were manifested. In 20 patients the neurological conditions exhibited an improvement, whereas in 4 patients no change was seen, although all 4 patients had shown atrophy of the spinal cord. Finally, I patient developed a C5 nerve dysfunction, which was presumably caused by the tethering of the posteriorly shifted cord following decompression. Based on these findings, it thus was concluded that an expansive laminoplasty with a unilateral opening is a safe and reliable procedure for cases manifesting a cervical spondylotic myelopathy due to a narrowed canal and/ or multisegmental spondylosis.
