The Comparison of Hemilaminectomy and Laminoplasty Procedures in the Surgical Treatment of Cervical Spondylotic Myelopathy
AIM: To compare cervical hemilaminectomy with cervical laminoplasty to determine the prognostic significance of both methods
in cervical spondylotic myelopathy (CSM). This study is first in the literature to compare the hemilaminectomy and laminoplasty
MATERIAL and METHODS: A total of 42 patients who underwent surgery due to CSM and followed for at least 24 months were
included in the study. Thirty-four out of 42 patients were males, while 8 were females; the mean age of the patients was 63.6
years (range 41-80). The visual analog scale (VAS) was used in the evaluation of postoperative axial neck pain. Factors known to
affect prognosis of CSM such as patients" age, gender, duration of symptoms, pressure level, and T2-hyperintense appearance
on magnetic resonance imaging (MRI) were evaluated. Patients were compared in terms of sagittal alignment of the vertebrae
(instability), anterior-posterior diameter of the spinal canal, transsectional spinal canal area, axial neck pain, and recovery rate based
on the preoperative and postoperative Japanase Orthopaedic Association (JOA) scores.
RESULTS: The recovery rate in patients who underwent hemilaminectomy was 60.8%±18.8, while in patients that underwent
laminoplasty it was 52.8%±11.9. The comparison of both surgical techniques in terms of postoperative recovery rates did not show
any significant difference between the techniques (p>0.05).
CONCLUSION: There were no significant differences in terms of recovery rate, preoperative and postoperative canal diameter,
preoperative and postoperative spinal canal area, and postoperative sagittal alignment (p>0.05). The VAS evaluating axial neck pain
was significantly lower in patients from the hemilaminectomy group compared to patients from the laminoplasty group.