Long Term Follow-up Review of Posterior Approaches for Cervical Spondylotic Myelopathy

Abstract

This paper presents the clinical results of patients with posterior approaches for cervical spondylotic myejopathy (CSM) more than 10 years after surgery. There were 42 males and 14 females with ages ranging from 39 to 79 years old (average 55 years). The duration of follow-up ranged from 10 years to 35 years (average 17 years). Operative procedures consisted of 36 laminoplasties and 20 conventional laminectomies.
At the time of discharge, 40 patients (71%) were excellent of good. At the time of the follow-up (average of 17 years), there were 28 patients (48%) in these categories. The best clinical results were obtained 1 year after surgery. After that the clinical results deteriorated gradually. Deterioration was usually seen from 3 to 7 years post operatively. In the clinical results, laminoplasty was better than laminectomy.
In the laminoplasty, spinal canal has been maintained to be enlarged. And postoperative malalignment was rare and postoperative ROM of neck was 60% of preoperative. Conventional laminectomy occurred postoperative malalignment due to destruction of posterior parts of the cervical spine. Laminoplasty was very useful at the point of postoperative malalignment. However laminectomy still remains the preferable option in certain elderly patients with limited ROM of the neck and need quick operation.