Expansive Open-door Laminoplasty for Cervical Compressive Myelopathy due to Multisegmental Spondylotic Canal Stenosis and OPLL : Evaluation of Clinical Outcome and Prognostic Factors

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Expansive laminoplasty has been widely used for treatment in patients with cervical compressive myelopathy. We evaluated the usefulness of expansive laminoplasty for patients with cervical canal stenosis due to multisegmental cervical spondylosis (CS) and ossification of the posterior longitudinal ligament (OPLL), and analyzed how the preoperative prognostic factors affect the outcome in both diseases. The authors reviewed 57 patients with CS and 25 patients with OPLL, who underwent expansive open-door laminoplasty. Pre- and post-operative clinical symptoms were evaluated by the Japan Orthopedic Association (JOA) disability score. The influences of predictive factors on the clinical outcome were analyzed by evaluating the recovery rate. The mean functional recovery rate in JOA score was 60.5% in the CS group and 63.8% in the OPLL group, showing no significant difference between the two groups. While improvement in the lower limbs' motor function was better than that in the upper limbs in both groups, all the patients showed an improvement or reduction in symptoms of myelopathy. The mean recovery rate of sensory function was approximately 50% in both groups. In the CS group, the duration of symptoms and severity of preoperative disability singnificantly (p<0.05) affected the operative outcome. In the OPLL group, the severity of preoperative disability and severity of canal stenosis showed significant influences on the operative outcome. Open-door expansive laminoplasty in patients with cervical compressive myelopathy due to multisegmental CS or OPLL showed promising improvement of myelopathy. In order to improve the patient's disability, early decompressive surgery following proper diagnosis must be done in these patients.
日本脊髄外科学会の論文
2002-07-31

Expansive Open-door Laminoplasty for Cervical Compressive Myelopathy due to Multisegmental Spondylotic Canal Stenosis and OPLL : Evaluation of Clinical Outcome and Prognostic Factors

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