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Analysis of the outcome in patients with cervical spondylotic myelopathy, undergone canal expansive laminoplasty supported with instrumentation in a group of Indian population – a prospective study.

Subhadip Mandal, MS (ortho), DNB (ortho), MBBS, U. Banerjee, MS (ortho), DNB ortho, A.S. Mukherjee, MS (ortho), MBBS, Subhajyoti Mandal, MBBS, Srikanta Kundu MS (ortho), MBBS

Department of Orthopaedics, NRS Medical College & Hospital, Kolkata, India

Abstract

Background

Chronic compression of the cervical spinal cord leads to a clinical syndrome of cervical spondylotic myelopathy (CSM). Clinical symptoms of cervical spondylotic myelopathy (CSM) or cervical myeloradiculopathies result in spinal cord and root dysfunction. The primary aims of surgical intervention for multilevel myelopathy are to decompress the spinal cord and maintain stability of the cervical spine. Secondary aims are to minimize complications which include long-term pain and motion loss. Laminoplasty as either single-door or double-door technique and with/without instrumentation is an established mode of surgical treatment.

The purpose of our study was to evaluate the result of single-door laminoplasty technique, supported with instrumented fixation in patients with multilevel degenerative cervical spondylotic myeloradiculopathy.

Methods

A prospective and without control study has been conducted in the institution in 17 patients with CSM, operated by canal expansive single-door laminoplasty (Hirabayashi technique) between April 2010 to April 2015. These patients were followed up for at least 3 years with both clinical and radiographic evaluations.

Results

On clinical evaluation, 15 of the 17 patients (87%) experienced relief of their symptoms. According to the Nurick classification, 11 patients’ demonstrated improvement by one grade, two patients improved by two grades, two patients were unchanged and two had worsening of the Nurick grade.

Conclusions

The results of this study regarding the use of open-door laminoplasty with instrumented fixation suggest that this technique is a satisfactory alternative for cases of multilevel cervical spondylotic myelopathy without deformation.

Level of Evidence

Level III therapeutic study.

keywords: 
Cervical Spine, spondylotic myeloradiculopathy, single-door laminoplasty, instrumented fixation, Nurick clinical evaluation
Volume 10 Article 17
doi: 
10.14444/3017