Posterior cervical laminoplasty in the North American Population: A minimum of two year follow-up

Background: The efficacy of expansile cervical laminoplasty for cervical spondylotic myelopathy has been validated in the literature. To date, however, the majority of large, long-term data in the literature have originated in Japan. Few studies have originated from North America that include follow up greater than one year, and none of these includes a single surgeon's experience. This paper presents the retrospective results of a single surgeon with an average follow up of 47 months in a large population of North American patients. Methods: A single surgeon's series of 80 consecutive patients who underwent expansile open-door laminoplasty for cervical myelopathy was reviewed. The severity of disability was graded using the Nurick Functional Disability Score and the Miami Upper Extremity Function (MUEF) score. Patients were evaluated preoperatively, six months postoperatively, and at a minimum of 24 months postoperatively. All examinations were performed by a single physician. MRI scans of the cervical spine were obtained at four months postoperatively in all patients. Radiographs were used to evaluate postoperative lordosis. Results: Average length of follow up was 47 months. Nurick scores improved from an average of 2.3 preoperatively to postoperative scores of 1.5 (p > .05) at six months and 1.4 (p > .05) at two years. MUEF scores also improved at both the six month and two year intervals. All patients had improved canal diameter on post-operative MRI scan evaluation obtained four months post-operatively. Conclusion: This study confirms that laminoplasty is a safe and effective treatment of cervical spondylotic myelopathy in the North American population. Level of evidence: Case Series Level IV. (C) 2015 Published by Elsevier B.V.