Comparison of Early Surgical Outcome between Unilateral Open-Door Laminoplasty and Midline Splitting Laminoplasty.

Baek, Hyun Chul; Kang, Suk Hyung; Jeon, Sang Ryong; Roh, Sung Woo; Rhim, Seung Chul

Original Article

Journal of Korean Neurosurgical Society 2007;41(6): 382-386.

Hyun Chul Baek, Suk Hyung Kang, Sang Ryong Jeon, Sung Woo Roh, Seung Chul Rhim

Department of Neurological Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. scrhim@amc.seoul.kr

ABSTRACT

OBJECTIVE
S: Various techniques of cervical laminoplasty have been developed to decompress the spinal canal in patients with multilevel cervical spondylotic myelopathy. This study compared the early surgical outcomes between unilateral open-door laminoplasty and midline splitting cervical laminoplasty. MATERIALS AND METHODS: From March 2004 to August 2005, we performed cervical laminoplasty in 34 patients with cervical myelopathy. Of these patients, 24 were treated by unilateral open-door laminoplasty (open-door group) and 10 by midline splitting cervical laminoplasty (splitting group). The mean duration of follow up was 9.2 months in the open-door group and 15.8 months in the splitting group. We retrospectively analyzed neurological outcomes using the Japanese Orthopedic Association (JOA) score, and compared the radiological changes between the two groups.
RESULTS
Postoperative JOA score and recovery rate were 13.29+/-4.01 and 56.28+/-44.91% in the open-door group and 15.75+/-0.88 and 72.69+/-19.99% in the splitting group. There was no statistical difference between the two groups (p>0.05). Regarding the radiological assessment, the increase of postoperative axial canal area was 63.23+/-23.24% in the open-door group and 42.30+/-14.96% in the splitting group (p<0.05).
CONCLUSION
There was no statistical difference in the neurological outcome when the early surgical outcomes of the open-door group and the splitting group were compared. However, the open-door group showed wider cervical spinal canal areas than the splitting group.

Key Words: Cervical vertebrae; Myelopathy; Surgical procedure; Outcome; Spinal canal