PT  - JOURNAL ARTICLE
AU  - Zhao-Quan Liu
AU  - Cheng-Ta Hsieh
AU  - Chih-Ta Huang
AU  - Szu-Kai Hsu
AU  - Jing-Jing Fang
AU  - Chih-Ju Chang
TI  - Combining Laminoplasty With Artificial Disc Replacement for the Treatment of Cervical Spondylotic Myelopathy With Congenital Cervical Stenosis
AID  - 10.14444/8475
DP  - 2023 May 26
TA  - International Journal of Spine Surgery
PG  - 8475
4099  - https://www.ijssurgery.com/content/early/2023/05/25/8475.short
4100  - https://www.ijssurgery.com/content/early/2023/05/25/8475.full
AB  - Background Cervical spondylotic myelopathy (CSM) is a very common and devastating spinal disease. Congenital cervical stenosis (CCS) is the most common cause. We aimed to elucidate the security, effectivity, and feasibility of surgery combining laminoplasty with artificial disc replacement (ADR) to treat CSM patients with radiculopathy, especially for preserving the range of motion (ROM) of the cervical spine.Method Between August 2008 and April 2019, 39 patients with multiple CSM caused by CCS were enrolled in the present study. All patients received laminoplasty first and then ADR. We used a retrospective collection of data for evaluating the functional and radiologic outcomes, especially regarding preservation of ROM.Results Each patient underwent at least a 2-year postoperative follow-up. The Japanese Orthopedic Association score showed great improvements at 6 months. The ADR index-level ROM was preserved during follow-up. The subaxial Cobb angle could also be retained in the whole cervical spine, and the spinal canal diameter could be expanded by more than 52.6%. There were no severe complications or side effects, and no patients needed secondary surgery.Conclusions We aimed to treat multiple levels of CSM with adequate decompression without too many intervertebral disc replacements. We were able to expand the spinal canal directly for these patients with CCS and needed only 1- or 2-level ADR to treat them with associated radiculopathy. This combined surgical strategy was secure, effective, and was able to preserve the ROM of the cervical spine.Level of Evidence 4.