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  • Combined Laminoplasty and Posterior Fusion for Treatment of Cervical Spondylotic Myelopathy: Systematic Review of the Literature

    Final Number:

    Kelly Bridges; Lauren Nicole Simpson MD; Carli Bullis MD; Christina M. Sayama MD; Khoi Duc Than MD

    Study Design:

    Subject Category:

    Meeting: Section on Disorders of the Spine and Peripheral Nerves Spine Summit- 2017

    Introduction: The authors describe a systematic literature review of laminoplasty in combination with posterior instrumented fusion for treatment of cervical spondylotic myelopathy (CSM).

    Methods: A US National Library of Medicine PubMed search was conducted for manuscripts pertaining to cervical laminoplasty and fusion for management of CSM. Several relevant studies were found for review, and manuscript bibliographies searched for additional references. The search was limited to human studies, English-language literature, and reports with more than 1 patient.

    Results: Combined laminoplasty and fusion was found to result in at least comparable, if not superior, neurological outcomes in specific patient populations with cervical spondylotic myelopathy. Japanese Orthopedic Association (JOA) scores, local kyphosis, and C2-C7 angle were reviewed in many manuscripts, and improvement in each of these categories was found with laminoplasty and fusion.

    Conclusions: The treatment of CSM necessitates an individualized approach based on pathoanatomical variation. Laminoplasty and fusion can be appropriately used for patients with CSM in the setting of local kyphotic deformity, ossification of the posterior longitudinal ligament, associated segmental instability, and need for strong stabilization.

    Patient Care: Utilization of laminoplasty for preservation of the posterior elements with concomitant fusion may provide benefit in this scenario, as well as other unexplored scenarios, and should be considered.

    Learning Objectives: By the conclusion of this session, participants should be able to understand the benefits of combined laminoplasty and fusion in the setting of cervical spondylotic myelopathy in various settings including local kyphotic deformity, Ossification of the Posterior Longitudinal Ligament (OPLL), and athetoid cerebral palsy.

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