Combined expansive open-door laminoplasty with short-segment lateral mass instrumented fusion for multilevel cervical spondylotic myelopathy with short segment instability

Objectives: Expansive open-door laminoplasty (EOLP) is an effective procedure for multilevel cervical spondylotic myelopathy (MCSM). It preserves a higher range of cervical motion than laminectomy with fusion and reserves more posterior elements than laminectomy alone. MCSM with short-segment instability or correctable local kyphosis often requires long-segment decompression and adequate segment fusion.

Materials and methods: We retrospectively reviewed 20 patients who received EOLP with short-segment posterior lateral mass instrumented fusion at our institution from 2008 to 2011. The follow-up period was at least 36 months. Postoperative functional and radiographic outcomes were collected and analyzed.

Results: Japanese Orthopedic Association scores improved significantly 36 months after surgery and the average recovery ratio was 85.3 ± 14.7%. Nurick disability scores and neck pain visual analog scale scores considerably decreased 3 years after surgery. No patients had aggravated neck pain or C5 nerve palsy during follow-up. The preservation of range of motion was approximately 60% after 36 months. No implant loosening or laminar collapse was reported on radiographic follow-up.

Conclusion: EOLP with concomitant lateral mass instrumented fusion yields favorable short-term clinical results for MCSM with short segment instability.