Cervical laminoplasty developments and trends, 2003-2013: a systematic review

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Laminoplasty is a common posterior cervical decompression technique.
• Its efficacy and advantages over laminectomy are not fully established.
• Key concerns include kyphosis, axial neck pain, range of motion, and C-5 palsy.

Purpose of the Study:

• To comprehensively review the laminoplasty literature from 2003-2013.
• To focus on specific clinical outcomes: kyphosis, axial neck pain, cervical range of motion, and C-5 palsy.

Main Methods:

• Medline database search for articles published between 2003 and 2013.
• Inclusion of case series reporting patient outcomes after laminoplasty.
• Exclusion of studies not reporting specified outcome measures.

Main Results:

• 103 studies comprising 130 patient groups (8949 patients) were analyzed.
• Japanese Orthopaedic Association (JOA) scores improved significantly (9.91 to 13.68).
• Cervical alignment remained stable; muscle-sparing techniques decreased kyphosis.
• Mean loss of range of motion was 47.3%; mean postoperative axial neck pain was 30% of patients.
• C-5 palsy rates varied, with 16% of studies reporting >10% incidence.

Conclusions:

• Laminoplasty is a valid surgical option for spinal cord decompression.
• Advancements in understanding the muscle-ligament complex and surgical hardware have improved outcomes.
• Variable reporting of outcome metrics complicates comparative analysis of different laminoplasty techniques.