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KMID : 1143720090050020074
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Korean Journal of Neurotrauma
2009 Volume.5 No. 2 p.74 ~ p.78
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The Effect of Open-Door Laminoplasty for Treatment of Acute Traumatic Cervical Spinal Cord Injury
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Kim Young-Ha
Son Dong-Wuk
Kim Sung-Hoon
Lee Sang-Won
Song Geun-Seong
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Abstract
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Objective:Open-door laminoplasty is an effective surgical technique in the treatment of multi-level cervical spondylotic myelopathy. In the present study, we reviewed the safety and short-term neurological outcome after open-door laminoplasty in the treatment of traumatic cervical cord injury.
Methods:We retrospectively reviewed our database over a 3-year period (January 2005-December 2007) and identified 18 surgically treated traumatic cervical spinal cord injuries without overt fracture or instability. All of these patients underwent open-door laminoplasty. Neurological function was assessed using the American Spinal Injury Association (ASIA) impairment scale. We collected data on the preoperative and the immediate postoperative and 2-month neurological examinations. We also reviewed the occurrence of complications and short-term radiological stability after the index procedure.
Results:There were 2 female and 16 male patients, with a mean age of 57.0(±6.0) years. All patients had hyperextension injuries with underlying cervical spondylosis, stenosis and ossification of posterior longitudinal ligament (OPLL) in the absence of overt fracture or instability. The average duration from injury to surgery was 1 day. The preoperative ASIA grade scale was grade A: 9 patients (50%), grade C: 3 patients (17%), and grade D: 6 patients (33%). There were no case of immediate postoperative deterioration or at 2 months follow-up. Neurological outcome (ASIA grade) of 13 patients (72.2%) were improved when examined 2 months after operation. We have no case of neurologic complication and radiological instability.
Conclusion:Open-door laminoplasty is a safe, low-morbidity, decompressive procedure. Surgical intervention consisting of open-door laminoplasty can be safely applied in the subset of patients with acute cervical cord injury who have significant cervical spondylosis/stenosis.
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KEYWORD
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Laminoplasty, Spinal cord injury, Spinal fracture
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