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Delayed segmental motor paralysis following laminoplasty: two case reports
1Department of Orthopaedic Surgery, Graduate school of Medical and Dental Sciences, Kagoshima University, Kogoshima, Japan.
Spinal Cord
|December 1, 2005
Summary
Delayed segmental motor paralysis can occur years after laminoplasty due to facet joint degeneration and spur formation. Surgical decompression improved symptoms in two patients, highlighting the need for long-term follow-up.
Area of Science:
- Orthopaedic Surgery
- Neurosurgery
- Spinal Cord Injury
Background:
- Laminoplasty is a surgical procedure to enlarge the spinal canal.
- Delayed neurological deficits after spinal surgery are uncommon but can significantly impact patient function.
Observation:
- Two patients developed segmental motor paralysis years after undergoing laminoplasty.
- Symptoms included weakness in deltoid and biceps muscles.
- CT myelography revealed posterior spur formation and hypertrophic facet joints at the operated level.
Findings:
- Posterior foraminotomy at the C4-C5 level was performed in both patients.
- Both patients experienced improvement in motor weakness post-surgery.
Implications:
- Laminoplasty can disturb facet joints, leading to degeneration and potential nerve root compression years later.
- This mechanism can cause delayed segmental motor paralysis.
- Long-term observation is crucial for patients who have undergone laminoplasty to detect and manage delayed complications.
