Comparison of surgical outcomes after cervical laminoplasty: open-door technique versus French-door technique.

STUDY DESIGN

A retrospective case series.

OBJECTIVE

To compare the surgical outcomes of open-door and French-door cervical laminoplasty for decompressing multilevel cervical spinal cord compressions.

SUMMARY OF BACKGROUND DATA

Cervical laminoplasty is an effective method for decompressing multilevel cervical spinal cord compressions. Laminoplasty is usually classified as an open-door or French-door technique, but it is still unclear whether laminoplasty affects cervical alignment and clinical outcomes.

METHODS

Fifty-one patients underwent cervical laminoplasty over a 2-year period for cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament, or for a mixed-type condition. The following criteria were evaluated and compared retrospectively for open-door laminoplasty (group A) and French-door laminoplasty (group B): Nurick grades, Japanese Orthopedic Association (JOA) scores, neck disability index, and visual analog scale scores for axial neck pain and radiating pain. During radiologic evaluations, changes in cervical lordotic angles and range of motion were measured at C2-C7.

RESULTS

Postoperatively, radiating pain improved significantly in both groups (P<0.05), but axial neck pain was more severe in both groups at last follow-up than preoperatively (P>0.05). Mean neurological improvement was 12.5% according to Nurick grades and 28% according to JOA scores in all study subjects. In particular, the mean Nurick grades showed significant improvement in group A (P<0.05), and the recovery rate was higher in group A than in group B according to Nurick grades (23.5% vs. 6.3%; P<0.05) and JOA scores (44.4% vs. 13%; P<0.05). In contrast, radiologically, cervical lordotic angle and range of motion were more significantly decreased in group B (P<0.05).

CONCLUSIONS

Although open-door and French-door laminoplasty techniques were found to be effective for treating cervical compressive myelopathy, the open-door technique seems to be superior with respect to clinical and radiologic outcomes.