Outcome and Incidence of Spinal Instability Following Laminectomy for Cervical Spondylotic Myelopathy

Abstract

Background Data: Laminectomy for cervical spondylotic myelopathy with no signs of instability is a standard surgical option but it may be associated with postlaminectomy kyphosis. Study Design: Retrospective clinical case study.Purpose: To evaluate the clinical outcome in a series of patients who underwent laminectomy for cervical myelopathy with special stress on the incidence of postoperative spinal instability. Patients and Methods: This study included twenty two patients who underwent laminectomy at a single or more levels, without fusion, for cervical spondylotic myelopathy. The clinical assessment included history taking, neurological examination and postoperative clinical outcome. The radiological assessment included magnetic resonance imaging, computed tomography, and plain anteroposterior, lateral, and lateral flexion-extension X-rays of the cervical spine. The postoperative clinical outcome was assessed in comparison with the preoperative condition as: improved, stable or worsened. Results: Improvement of gait disturbance occurred in 69% of the concerned patients. Sensory deficits and radicular pain improved in the upper limbs (UL) and lower limbs (LL) in 73% and 50%, respectively. Motor deficits improved in the UL and LL in 69% and 55% of the patients, respectively. Postoperative clinical deterioration occurred in two patients (9.1%) and one patient (4.5%) developed postoperative kyphosis. Conclusion: Laminectomy usually results in improvement of the neurological deficits and radicular pain in patients with cervical spondylotic myelopathy with low incidence of postoperative clinical deterioration and instability. (2015ESJ081)