Cervical laminoplasty: a critical review

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedics

Background:

• Cervical laminoplasty is a surgical technique to decompress the spinal canal in patients with multi-level anterior compression.
• Conditions like ossification of the posterior longitudinal ligament and cervical spondylosis often necessitate this decompression.
• Evidence supporting laminoplasty's superiority over laminectomy in neurological outcomes, spinal stability, and preventing complications like postlaminectomy kyphosis is limited.

Purpose of the Study:

• To evaluate the efficacy of cervical laminoplasty compared to laminectomy.
• To assess neurological outcomes, preservation of spinal stability, and prevention of postlaminectomy kyphosis.
• To review the development of the
• postlaminectomy membrane
• and other complications.

Main Methods:

• A meta-analysis of English-language laminoplasty literature was conducted.
• Seventy-one series, comprising over 2000 patients, were reviewed retrospectively.
• Data assessed included neurological outcome, range of motion (ROM) changes, spinal deformity, and complications.

Main Results:

• No significant difference in neurological outcome was found between laminoplasty techniques or when compared to laminectomy.
• Approximately 35% of patients experienced worsening cervical alignment post-laminoplasty, with 10% developing kyphosis.
• Cervical ROM decreased substantially (mean 50%), with progressive loss over time, similar to laminectomy and fusion outcomes.

Conclusions:

• Current literature does not substantiate the claimed benefits of cervical laminoplasty over laminectomy.
• Neurological outcomes and spinal alignment changes are comparable between laminoplasty and laminectomy.
• Laminoplasty patients experience progressive limitation in cervical ROM, mirroring results seen after laminectomy and fusion.