Tailor-Made Surgical Strategy for Coexistent Cervical Myelopathy and Bilateral Radiculopathy. Combined Laminoplasty, Laminectomy, and Foraminotomy: Report of Two Cases.

ABSTRACT

Cervical spondylosis is a common and degenerative disease consisting of myelopathy and radiculopathy. Surgical treatment can be considered for patients with cervical spondylosis resulting in severe pain, motor weakness, ambulation difficulty, and urination disorder. As myelopathy and radiculopathy often coexist, two-staged anterior and posterior fixation/decompression surgery can be selected to resolve those two pathologies. However, due to the invasiveness of that management, posterior surgery in a single session seems favorable. In this study, we present two cases of cervical spondylosis. A 67-year-old man was complaining of pain in the neck and right upper extremity. Radiographically, cervical canal stenosis was concurrently diagnosed with the foraminal stenosis of the left C3/4 and right C6/7. Laminoplasty from C3 to C6 (left open; C3 to C5, right open; C6) and foraminotomy of the left C3/4 and right C6/7 were performed in a single session. Another 43-year-old man was bothered by pain in the neck and bilateral upper extremities resulting from cervical canal stenosis and bilateral foraminal stenosis of C6/7. Laminoplasty from C3 to C5, laminectomy of C6, and foraminotomy of bilateral C6/7 were performed in a single session. Preoperative symptoms were remitted in both cases. As described in our cases, a tailor-made combination of laminoplasty, laminectomy, and foraminotomy can effectively resolve cervical spondylosis in a single session.