Fracture of the axis after dome-like cervical laminoplasty

We describe a case of fracture of the axial neural arch that occurred after a dome-like cervical laminoplasty and caused dural compression. Cervical laminoplasty with dome-like laminoplasty of the axis was performed on a patient with cervical myelopathy due to ossification of the posterior longitudinal ligament extending from C2 to C6. After temporary neurological remission, the patient experienced unanticipated neurological deterioration with posterior cervical pain. Radiographs, magnetic resonance imaging and computed tomography of the cervical vertebrae showed a fractured axial lamina that was compressing the cervical cord. After total axial laminectomy, permanent neurological improvement was obtained. Our experience suggests that care should be taken to avoid an excessive dome-like laminoplasty and that the possibility of axial fracture should be borne in mind.