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Cervical laminoplasty: indication, technique, complications.

Douglas S Weinberg1, John M Rhee1

  • 1Department of Orthopaedic Surgery, The Emory Spine Center, Emory University School of Medicine, Atlanta, Georgia, USA.

Journal of Spine Surgery (Hong Kong)
|April 21, 2020
PubMed
Summary
This summary is machine-generated.

Cervical laminoplasty offers a non-fusion surgical option for cervical spondylotic myelopathy (CSM). This procedure expands the cervical spinal canal, potentially yielding outcomes comparable or superior to fusion methods.

Keywords:
Sagittal balancecervical myelopathycervical spine surgerycervical stenosislaminoplasty

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Orthopedic Surgery

Background:

  • Cervical spondylotic myelopathy (CSM) is a condition affecting the spinal cord in the neck.
  • Multilevel cervical stenosis is a common cause of CSM.
  • Non-fusion decompression techniques are sought to avoid fusion-related complications.

Purpose of the Study:

  • To describe cervical laminoplasty as a non-fusion decompression procedure for CSM.
  • To outline indications, contraindications, and technical considerations for cervical laminoplasty.
  • To compare outcomes of cervical laminoplasty with other surgical options for CSM.

Main Methods:

  • Cervical laminoplasty involves expanding the laminar arch to decompress the spinal canal.
  • Patient selection criteria include multilevel stenosis with preserved sagittal alignment and minimal axial neck pain.
  • Contraindications involve significant preoperative neck pain, kyphotic alignment, and instability.

Main Results:

  • Cervical laminoplasty allows for direct and indirect decompression of the cervical spinal canal.
  • Potential advantages include avoiding fusion complications and preserving cervical motion.
  • Meticulous management of extensor muscles and soft tissue attachments to C2 is crucial.

Conclusions:

  • Cervical laminoplasty is indicated for select CSM patients with multilevel stenosis.
  • Outcomes in properly selected patients are comparable or superior to laminectomy and fusion.
  • This technique offers a motion-preserving alternative to fusion for cervical decompression.