Duraplasty with laminoplasty for Hirayama disease: a technical note with a case series

Hirayama disease, a form of cervical myelopathy predominantly affecting young males, is characterized primarily by distal muscle atrophy in the upper limbs. We investigated the surgical outcomes of duraplasty with laminoplasty for Hirayama disease. Five male patients with an average age of 17.4 years with Hirayama disease who had preoperative muscle atrophy and numbness in the upper extremities underwent duraplasty with laminoplasty. The severity of disability in activities of daily living was classified using the Tokumaru classification. Following cervical duraplasty with laminoplasty, all patients experienced significantly improved upper extremity performance. Hirayama disease is characterized by an inelastic dura that constricts and compresses the cervical spinal cord when the neck is flexed. Duraplasty with laminoplasty is proposed as an effective treatment for Hirayama disease.