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Cervical Laminoplasty in the Elderly Report of a Single Center Experience and Review of the Literature

机译：Cervical Laminoplasty in the Elderly Report of a Single Center Experience and Review of the Literature

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Background: Cervical laminoplasty has become one of the most endorsed surgical techniques for the treatment of multilevel spondylotic myelopathy, especially in the elderly. It can avoid an extensive anterior neck surgery in any case where there is not a pre-existing kyphosis or evidence of abnormal spinal movement. Methods: We report our retrospective single centre experience with open-door laminoplasty for multilevel cervical myelopathy in an elder population, focusing on both radiological and functional outcomes to compare our results with the recent literature. Results: Among the 30 selected subjects, 2 (6, 7%) showed surgical complications that required re-intervention and were excluded from the study. All the others 28 patients (93,3%), with a minimum follow-up of 18 months, showed adequate decompression of the spinal canal at the post-operative MRI, no persistent axial pain nor persistent postoperative complications. The majority of patients showed an improvement of both the Nurick scale and the mJOA score during follow up, with an ultimate median value of the mJOA recovery rate of 69,7%.The median value of C2- C7LA of the 18 evaluated patients at 18 months after surgery was 17,4°, with a medium loss of lordosis of about 5,2 degrees. Conclusions: Our study has the limitations of a retrospective review with a limited amount of patients; nevertheless the clinical and radiological outcomes of our patients confirm the good results of this surgical approach. Its effectiveness in improving cervical spinal cord compression mixed with its lower risk of developing or worsening kyphosis made it an undeniable resource in surgeons’ armamentarium.

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