Persistent physical symptoms after laminoplasty: analysis of postoperative residual symptoms in 520 patients with cervical spondylotic myelopathy.

STUDY DESIGN

A large-scale retrospective study of analysis of postoperative residual symptom in patients with cervical spondylotic myelopathy (CSM).

OBJECTIVE

The purpose of this study was to investigate which symptom remains postoperatively in a large series of patients with CSM.

SUMMARY OF BACKGROUND DATA

CSM is an increasingly common neurological disorder of the geriatric population. Cervical laminoplasty is an established procedure for the decompression of multisegmental CSM, and numerous studies have documented satisfactory surgical results. However, no report has yet elucidated the postoperative residual symptoms in patients with CSM.

METHODS

Between April 1995 and December 2006, 520 consecutive patients with CSM who underwent laminoplasty were enrolled in this study. They were 331 males and 189 females, and mean age was 62.2 years. Severity of myelopathy was evaluated according to a scoring system proposed by the Japanese Orthopedic Association for cervical myelopathy. Each functional improvement was expressed by the recovery rate (RR) of the Japanese Orthopedic Association score.

RESULTS

The average follow-up period was 33.3 months. The mean recovery rates of motor function of the upper and lower extremities were 59.6% and 44.9%, respectively. The mean recovery rates of sensory function of the upper extremity, lower extremity, and trunk were 48.1%, 56.6%, and 54.6%, respectively, and that of urinary bladder function was 59.6%.

CONCLUSION

Motor function impairments of the lower extremities and sensory function impairments of the upper extremities persist more than other symptoms after surgery. Such findings should be incorporated within treatment-planning discussions.