Cervical single open door laminoplasty with lateral mass screw fixation for the treatment of cervical spondylotic myelopathy with cervical instability

Abstract

To evaluate the outcomes of single open door laminoplasty with lateral mass screw fixation in treating cervical spondylotic myelopathy (CSM) with cervical instability. From March 2010 to October 2012, 25 patients with spondylotic myelopathy and cervical instability underwent single open door laminoplasty with lateral mass screw fixation. There were 18 males and 7 females, aged from 57 to 68 years with the mean of 57 years. Japanese Orthopaedic Association (JOA) scores were used to evaluate clinical effects before operation and final follow up. Radiographical measures were made in change of Cobb angle by sagittal plane from C₂ to C₇, and cervical range of motion. All the patients were followed up from 18 to 36 months with an average of 25.6 months. Cerebrospinal fluid leakage occurred in 1 case, incision fat necrosis in 1 case, C₅ nerve root palsy in 4 cases. JOA scores was improved from preoperative 5.2±2.1 to 11.3±2.4 final follow up. Cobb angle was changed from preoperative (6.5±3.4)° to (13.2±4.9)° final follow up. Cervical range of motion was changed from preoperative (30.4±9.2)° to (26.5±8.4)° final follow up. As an effective treatment to CSM with cervical instability, single open door laminoplasty with lateral mass screw fixation has the advantage of extensive application scope, safety and steady, but the incidence rate of complication must be reduced.