2012 Volume 26 Issue 3 Pages 304-311
Object : We experienced 12 patients who underwent additional surgery after anterior decompression and fusion (ADF) or expansive laminoplasty (ELP). We examined the clinical course and the causes of occurring cervical myelo-radiculopathy in the cases.
Materials and Methods : 278 patients who underwent modified trans-unco-discal approach (TUD) with iliac bone graft, or ELP using spinous process or ceramic spacers were reviewed for the neurological symptoms, Japanese Orthopaedic Association (JOA) score. Twelve patients who needed additional operation were examined regarding its clinical course and the causes for myelo-radiculopathy.
Results : The pathogenesis in which those cases needed re-operation were 1) inadequate decompression, 2) instability, and 3) adjacent inter-vertebral lesions. Improvement of neurological symptoms after second operation is less than that after the first operation.
Conclusions : Thorough decompresson of the cord including its lateral aspect is crucial for good results of ELP in cases with OPLL (ossification of posterior longitudinal ligament). If the cases have the instability, complete stabilization should be obtained. Adjacent lesions after ADF persist to be one of the causes for the revision.
