[Cervical laminoplasty--review of surgical techniques, indications, methods of efficacy evaluation, and complications]

Abstract

Techniques of expansive cervical laminoplasty evolved in the 1970s in Japan as an alternative to laminectomy connected with many complications. They were developed and modified in the following years. Nowadays cervical laminoplasty is the standard method of posterior decompression of the cervical spine which reflects the aspiration to preserve the spine stabilising structures. Indications for laminoplasty are multilevel cervical pathological changes leading to spinal canal stenosis and myelopathy as a consequence. Historical background is discussed. Technical details of Z-type laminoplasty (Oyama), open-door laminoplasty (Hirabayashi), spinous process-splitting laminoplasty (Kurokawa), hardware-augmented laminoplasty (O'Brien with Shaffrey's modification) and dorso-lateral decompression (Ohtsuka) are described. The Japanese Orthopaedic Association scale is widely accepted for the clinical evaluation of cervical myelopathy. Effectiveness of surgical treatment is evaluated using the Hirabayashi recovery rate. Postoperative complications are: diminution of neck motion range, kyphotic deformity, axial neck pain, C5 nerve root palsy, restenosis and late deterioration of neurological postoperative outcome. Contemporary theories explaining problems connected with the complications are described. The subject is discussed based on a review of literature and own practice.