Aim:We have aimed to evaluate the clinical success of the en bloc laminoplasty and impact of the arcocristectomy on postoperative axial pain of the patients with cervical spondylotic myelopathy (CSM).
Material and Methods:A retrospective review of 81 patients with CSM who underwent an en bloc cervical laminoplasty with preserving posterior structure of the cervical spine during the period from 2007 to 2014 was performed. Arcocristectomy was performed if C6-7 level included to surgery. The posterior spinal elements and muscles attached to spinous process of C2 and C7 are preserved. Thus, postoperative deformity of the cervical spine could be avoided. Neurologic status was assessed using modified Japanese Orthopedic Association (JOA) scale score. Neurological recovery rate calculated according to Hirabayashi method
Results:The mean modified JOA scale score was 11.4±2.4 preoperatively and 15.0±3.9 postoperatively. Neurological recovery rate was 68.6%. C7 arcocristectomy was performed in 19 patients. No axial pain was noted in the postoperative 2 months. Keyhole foraminotomies were preformed in 11 patients and radicular pain completely resolved after surgery. Temporary 5th nerve root palsy was observed in 3 patients. Mean cervical spine lordosis was 10.6±10.5 preoperatively and 8.6±9.5 postoperatively. No postoperative spinal instability and kyphotic deformity were noted.
Conclusion:En bloc cervical laminoplasty with preserving posterior structure is useful in preventing postoperative spinal malalignment and axial pain. Arcocristectomy is an effective technique for prevention of postoperative axial pain in patients with C6-7 narrow spinal canal.
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