Investigation of the Efficacy of Bilateral Osteoligamentous Decompression via Hemilaminectomy in Cervical Spondylotic Myelopathy: A Clinical Study

OBJECTIVE: Cervical stability may deteriorate and kyphotic spinal deformities may develop in cervical spondylotic myelopathy (CSM) after laminectomy or lam-inoplasty. This study aimed to investigate the therapeutic efficacy of the "bilateral osteoligamentous decompression via unilateral hemilaminectomy approach (UHBOLD)" technique in CSM patients.METHODS: The study included 34 adult patients who u nderwent UHBOLD surgery for CSM between 2016 and 2022. A record was made for all patients of age, gender, n umber of operated levels, preoperative and postoperative long-term follow-up VAS scores, Nurick grade values and mJOA scores, kyphosis angles measured on X-ray, and spinal canal areas measured on T2-weighted MR axial images.RESULTS: Preoperative VAS scores of the patients were 6 (4-9), Nurick grade values were 3 (2-5), mJOA scores were 10.50 +/- 3.42, kyphosis angles were-13.34 +/- 13.69(degrees) and spinal canal areas were 87.11 +/- 28.30 mm(2). In post-operative long-term follow-up of these patients, VAS scores were 2 (1-5), Nurick grade values were 1 (0-5), mJOA scores were 13.94 +/- 3.09, kyphosis angles were-15.07 +/- 12.78(degrees) and spinal canal areas were 149.65 +/- 42.57 mm(2). A statistically significant difference was determined between the preoperative and the post-operative long-term follow-up VAS scores, Nurick grade values, mJOA scores, and spinal canal areas (P < 0.001). Kyphosis angles were not different (P [ 0.198), and no instability was observed in any patient in long-term follow-u p.CONCLUSIONS: The UHBOLD technique performed in multilevel CSM patients did not cause any change in cer-vical lordosis angle in long-term follow-up, did not cause cervical kyphotic deformity or cervical instability, and significantly improved Nurick grade values, and VAS and mJOA scores.