Laminoplasty: an evaluation of 24 cases

Cervical expansive laminoplasty has been advocated as an alternative procedure to laminectomy for the decompression of the cervical spine. It provides favourable cord decompression and stabilisation of the cervical spine and is a simpler and safer alternative to anterior fusion and laminectomy for myelopathy and myeloradiculopathy, due to multisegmental cervical spondylosis and ossified posterior longitudinal ligament. We report our experience in 24 patients with this procedure, 12 of whom had myelopathy and another 12 had myeloradiculopathy. The earliest symptom to improve was radicular pain or paraesthesia (75%). A reduction in spasticity was seen in 21 of the 24 patients (87.5%). Eleven patients had improvement in their motor power during a follow up period ranging from 1 month to 14 months. One patient deteriorated following the procedure and developed Brown Sequard features due to under riding of the lamina on the hinged side, another had severe post operative paraesthesias, while one patient had a CT scan evidence of 'closing of the door', without being symptomatic for it. The technique of the procedure is discussed and the pertinent literature reviewed.