Early complications after cervical single open-door laminoplasty in elderly patients with multilevel cervical spondylotic myelopathy

Abstract

Objective To analyze the early complications and treatment protocal after cervical single open-door laminoplasty in treatment of elderly patients with multiple segmental cervical spondylotic myelopathy. Methods A total of 125 patients with multiple segmental cervical spondylotic myelopathy underwent cervical single open-door laminoplasty in the First Affiliated Hospital of Zhengzhou University from January 2010 to December 2015. There were 43 cases treated for 4 cervical vertebrae (C3 to C6, or C4 to C7) segments, and 82 cases for C3 to C7 segments. X-ray, magnetic resonance imaging (MRI) and computed tomography (CT) examinations of cervical spine were performed before operation. The interspinous ligament of C2 or C7 was reserved as much as possible. All the patients underwent general anesthesia with tracheal intubation. Early complications were observed after operation, and the preoperative and postoperative Japanese Orehopedic Association (JOA) scores were recorded. Results Among the 125 patients, early complications occurred in 7 patients (8 times): 2 cases of spinal nerve dysfunction, 2 cases of cervical nerve root paralysis, 2 cases of cerebrospinal fluid leakage, 1 case of poor wound healing and 1 case of incision hematoma. The total complication rate was 6.40%(8/125). Through positive treatment, 7 patients recovered well, and the JOA score of them was 11 to 16, with an average of 13.9±1.5. Conclusions Cervical single open-door laminoplasty has a relative high complication rate in the treatment of elderly patients with multiple segmental cervical spondylotic myelopathy. However, the prognosis would be good by active prevention and treatment. Key words: Single open-door laminoplasty; Elderly; Posterior; Complication; Cervical spondylotic myelopathy