Cervical laminaplasty: its role in the treatment of cervical radiculopathy

Abstract

Krita in 1968 described the use of laminaplasty for the treatment of cervical myelopathy. Since then, several authors have modified this technique, settling on the "expansive open door laminaplasty" as the technique of choice for cervical myelopathy. There have been no reports to date on the use of the cervical laminaplasty procedure for the treatment of cervical radiculopathy. The purpose of this paper is to report on the initial 16 patients undergoing this procedure for the surgical treatment of cervical radiculopathy due to cervical spondylosis and/or cervical spinal stenosis. There were 16 patients (8 males and 8 females) whose age ranged from 54 to 84 years, with a mean of 67.2 years. The follow-up average was 2.7 years, with a range of 2.1 to 5.5 years. Seven patients were categorized as having brachalgia-cord type myelopathy and nine patients were categorized as radiculopathy only. Arm pain was unilateral in seven patients and bilateral in nine patients. Of those with bilateral pain, eight patients had pain predominately in one arm, with one patient having equal left and right arm complaints. Cervical laminaplasty was carried out from C3-6 in six patients and C3-7 in six patients and one patient had each of the following: C4-7, C4-T1, C5-T1, and C3-T1. The results were excellent in five cases, good in nine, and poor in two. The results of patients with unilateral symptoms and signs were compared to those with bilateral findings using chi 2 analysis. There was no statistical difference when performing laminaplasty for patients with bilateral findings as opposed to unilateral symptoms and signs. The amount of spinal canal expansion obtained by the laminaplasty procedure ranged from 4 to 12 mm. The conclusions of this study were (a) laminaplasty appears to be an effective alternative to laminectomy or anterior cervical fusion for multilevel cervical spondylotic radiculopathy or myeloradiculopathy and (b) complications of anterior fusion and laminectomy are avoided with the laminoplasty procedure.