Changes in Cervical Spine Range of Motion after Laminoplasty in Cervical Spondylotic Myelopathy

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: This study examined the cervical range of motion (ROM) of cervical spondylotic myelopathy patients, before and after open door laminoplasty. SUMMARY OF LITERATURE REVIEW: Majority of the cases regarding the change of cervical range of motion after cervical laminoplasty showed decreased range of motion, and the results were diverse. MATERIALS AND METHODS: Of the 487 patients, who underwent open door laminoplasty at our hospital from March 1997 to March 2008, 98 had been followed for at least 2 years and had cervical flexion-extension lateral x-rays. In all patients, open door laminoplasty involved at least three segments: three, four, and five segments in 11, 52, and 35 patients, respectively. In previous cases, fixation involved sutures using suture anchors. The lordosis or kyphosis between C2 and C7 was analyzed using cervical flexion-extension lateral radiographs before and 2 years after the operation. RESULTS: The average patient age was 62.7 (range 32-82) years; 65 patients were male and 33 were female. From preoperatively to postoperatively, the average kyphosis of cervical flexion decreased from 10.7degrees to 7.8degrees, average lordosis decreased from 21.2degrees to 14.2degrees, and cervical ROM decreased from 31.9degrees to 22.0degrees, respectively (mean 9.9degrees, 31.0%). CONCLUSIONS: We could observe decreased cervical range of motion after cervical laminoplasty for cervical spondylotic myelopathic patients. Thus, the treatment to prevent the postoperative decrease of cervical range of motion and further study to find a new treatment are thought to be essential.