Laminoplasty: a review of its role in compressive cervical myelopathy

James J. Hale, Konrad I. Gruson, Jeffrey M. Spivak

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background context: The currently accepted surgical treatments for compressive cervical myelopathy include both anterior and posterior decompression. Anterior approaches including multilevel discectomy with fusion or vertebral corpectomy with strut grafting, both with and without instrumentation, have enjoyed successful outcomes, but have been associated with select postoperative complications. Laminoplasty has been developed to decompress the spine posteriorly while avoiding the spinal destabilization seen after laminectomy. Purpose: The purpose of this article is to provide a review of the various techniques, biomechanical basis, predictive value of imaging modalities, clinical outcomes, and postoperative complications associated with cervical laminoplasty. Study design: A review of the literature. Methods: A comprehensive literature review using Medline was performed identifying relevant articles that addressed the techniques, clinical outcomes, and complications after cervical laminoplasty, as well as preoperative radiographic predictors of outcome. Results: The various modifications of cervical laminoplasty have generally been associated with excellent clinical outcomes when used for myelopathy secondary to cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL). Recent long-term studies have identified issues with this technique including axial neck pain, canal restenosis, nerve root palsy, diminished cervical motion, and loss of cervical lordotic alignment. Conclusions: Cervical laminoplasty remains a reliable procedure for posterior decompression of the spine, but the optimal approach to cervical myelopathy must take into account both patient and disease characteristics, as well as the capabilities and experience of the surgeon.

Original languageEnglish (US)
JournalSpine Journal
Volume6
Issue number6 SUPPL.
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

Spinal Cord Compression
Spinal Cord Diseases
Decompression
Spine
Ossification of Posterior Longitudinal Ligament
Spondylosis
Diskectomy
Laminectomy
Neck Pain
Paralysis
Laminoplasty

Keywords

  • Cervical myelopathy
  • Cervical spine
  • Laminoplasty
  • Nerve palsy
  • Posterior approach
  • Surgical management

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Laminoplasty : a review of its role in compressive cervical myelopathy. / Hale, James J.; Gruson, Konrad I.; Spivak, Jeffrey M.

In: Spine Journal, Vol. 6, No. 6 SUPPL., 11.2006.

Research output: Contribution to journalArticle

Hale, James J. ; Gruson, Konrad I. ; Spivak, Jeffrey M. / Laminoplasty : a review of its role in compressive cervical myelopathy. In: Spine Journal. 2006 ; Vol. 6, No. 6 SUPPL.
@article{fdf401a2d2864b9e9327ce36c9e5f02a,
title = "Laminoplasty: a review of its role in compressive cervical myelopathy",
abstract = "Background context: The currently accepted surgical treatments for compressive cervical myelopathy include both anterior and posterior decompression. Anterior approaches including multilevel discectomy with fusion or vertebral corpectomy with strut grafting, both with and without instrumentation, have enjoyed successful outcomes, but have been associated with select postoperative complications. Laminoplasty has been developed to decompress the spine posteriorly while avoiding the spinal destabilization seen after laminectomy. Purpose: The purpose of this article is to provide a review of the various techniques, biomechanical basis, predictive value of imaging modalities, clinical outcomes, and postoperative complications associated with cervical laminoplasty. Study design: A review of the literature. Methods: A comprehensive literature review using Medline was performed identifying relevant articles that addressed the techniques, clinical outcomes, and complications after cervical laminoplasty, as well as preoperative radiographic predictors of outcome. Results: The various modifications of cervical laminoplasty have generally been associated with excellent clinical outcomes when used for myelopathy secondary to cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL). Recent long-term studies have identified issues with this technique including axial neck pain, canal restenosis, nerve root palsy, diminished cervical motion, and loss of cervical lordotic alignment. Conclusions: Cervical laminoplasty remains a reliable procedure for posterior decompression of the spine, but the optimal approach to cervical myelopathy must take into account both patient and disease characteristics, as well as the capabilities and experience of the surgeon.",
keywords = "Cervical myelopathy, Cervical spine, Laminoplasty, Nerve palsy, Posterior approach, Surgical management",
author = "Hale, {James J.} and Gruson, {Konrad I.} and Spivak, {Jeffrey M.}",
year = "2006",
month = "11",
doi = "10.1016/j.spinee.2005.12.032",
language = "English (US)",
volume = "6",
journal = "Spine Journal",
issn = "1529-9430",
publisher = "Elsevier Inc.",
number = "6 SUPPL.",

}

TY - JOUR

T1 - Laminoplasty

T2 - a review of its role in compressive cervical myelopathy

AU - Hale, James J.

AU - Gruson, Konrad I.

AU - Spivak, Jeffrey M.

PY - 2006/11

Y1 - 2006/11

N2 - Background context: The currently accepted surgical treatments for compressive cervical myelopathy include both anterior and posterior decompression. Anterior approaches including multilevel discectomy with fusion or vertebral corpectomy with strut grafting, both with and without instrumentation, have enjoyed successful outcomes, but have been associated with select postoperative complications. Laminoplasty has been developed to decompress the spine posteriorly while avoiding the spinal destabilization seen after laminectomy. Purpose: The purpose of this article is to provide a review of the various techniques, biomechanical basis, predictive value of imaging modalities, clinical outcomes, and postoperative complications associated with cervical laminoplasty. Study design: A review of the literature. Methods: A comprehensive literature review using Medline was performed identifying relevant articles that addressed the techniques, clinical outcomes, and complications after cervical laminoplasty, as well as preoperative radiographic predictors of outcome. Results: The various modifications of cervical laminoplasty have generally been associated with excellent clinical outcomes when used for myelopathy secondary to cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL). Recent long-term studies have identified issues with this technique including axial neck pain, canal restenosis, nerve root palsy, diminished cervical motion, and loss of cervical lordotic alignment. Conclusions: Cervical laminoplasty remains a reliable procedure for posterior decompression of the spine, but the optimal approach to cervical myelopathy must take into account both patient and disease characteristics, as well as the capabilities and experience of the surgeon.

AB - Background context: The currently accepted surgical treatments for compressive cervical myelopathy include both anterior and posterior decompression. Anterior approaches including multilevel discectomy with fusion or vertebral corpectomy with strut grafting, both with and without instrumentation, have enjoyed successful outcomes, but have been associated with select postoperative complications. Laminoplasty has been developed to decompress the spine posteriorly while avoiding the spinal destabilization seen after laminectomy. Purpose: The purpose of this article is to provide a review of the various techniques, biomechanical basis, predictive value of imaging modalities, clinical outcomes, and postoperative complications associated with cervical laminoplasty. Study design: A review of the literature. Methods: A comprehensive literature review using Medline was performed identifying relevant articles that addressed the techniques, clinical outcomes, and complications after cervical laminoplasty, as well as preoperative radiographic predictors of outcome. Results: The various modifications of cervical laminoplasty have generally been associated with excellent clinical outcomes when used for myelopathy secondary to cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL). Recent long-term studies have identified issues with this technique including axial neck pain, canal restenosis, nerve root palsy, diminished cervical motion, and loss of cervical lordotic alignment. Conclusions: Cervical laminoplasty remains a reliable procedure for posterior decompression of the spine, but the optimal approach to cervical myelopathy must take into account both patient and disease characteristics, as well as the capabilities and experience of the surgeon.

KW - Cervical myelopathy

KW - Cervical spine

KW - Laminoplasty

KW - Nerve palsy

KW - Posterior approach

KW - Surgical management

UR - http://www.scopus.com/inward/record.url?scp=33750631548&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750631548&partnerID=8YFLogxK

U2 - 10.1016/j.spinee.2005.12.032

DO - 10.1016/j.spinee.2005.12.032

M3 - Article

C2 - 17097549

AN - SCOPUS:33750631548

VL - 6

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

IS - 6 SUPPL.

ER -