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David M. Benglis Jr., James D. Guest, and Michael Y. Wang

reason, a minimal access approach to cervical laminoplasty may be desirable. Minimally invasive posterior approaches to the cervical spine have recently been developed for the treatment of foraminal stenosis and lateral disc herniations. 3 , 22 Building on initial experiences with tubular dilator retractors used for lumbar microdiscectomy, several groups have begun applying this technique for cervical foraminotomy. In a landmark paper, Adamson 1 reviewed data from a series of 100 patients treated in this manner. He reported that 97% of the patients experienced good

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Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Hyun Chul Shin, Do Heum Yoon, and Yoon Ha

radiological parameters to determine whether cervical sagittal alignment after laminoplasty was related to clinical outcomes. Methods Patients and Operations This retrospective study occurred at Yonsei University Medical Center. A total of 286 patients who underwent cervical laminoplasty for OPLL between January 2005 and January 2013 were reviewed. Of these patients, we used data from those who underwent laminoplasty between January 2012 and January 2013. Our institution’s ethics committee approved the study. Patients with OPLL were excluded if their OPLL was

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Mikinobu Takeuchi, Norimitsu Wakao, Mitsuhiro Kamiya, Atsuhiko Hirasawa, Kenta Murotani, and Masakazu Takayasu

T he incidence of C5 palsy after cervical laminoplasty is approximately 5%. 3 , 6 , 10 , 14 C5 palsy can be caused by cervical foraminal stenosis, 8 , 9 reperfusion syndrome, 5 spinal cord shift, 16 or heat injury. 7 Particularly in cases of cervical foraminal stenosis, some reports have described presurgical predictive methods: thin-slice CT 8 and various MRI methods (oblique MRI 12 or MR myelography 2 ) to avoid C5 palsy after cervical laminoplasty. It is probable that cervical foraminal stenosis contributes to C5 palsy after cervical laminoplasty

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John K. Ratliff and Paul R. Cooper

reported. 1–3, 5–7, 76 Overall its incidence varies markedly and ranges from 6 to 60%. 12, 25, 31, 35, 39, 65, 78 It is not clear whether this variation is a function of the laminoplasty technique, the time at which neck pain is recorded in relation to surgery, the authors' assessment of what constitutes significant neck pain, or other unknown factors. Dysfunction of the C-5 Nerve Root Dysfunction of the C-5 nerve root may occur after anterior or posterior cervical surgery at the C4–5 level and is not peculiar to cervical laminoplasty. Unfortunately this

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Takeshi Oichi, Yasushi Oshima, Hiroyuki Oka, Yuki Taniguchi, Hirotaka Chikuda, Yoshitaka Matsubayashi, Katsushi Takeshita, and Sakae Tanaka

C ervical laminoplasty is a well-established surgical procedure with satisfactory long-term clinical outcomes in patients with cervical spondylotic myelopathy (CSM). 1 , 11 , 16 However, cervical laminoplasty is associated with some postoperative complications, including C-5 palsy 2 and axial symptoms. 20 Furthermore, several investigators have reported the occurrence of interlaminar bony fusion after cervical laminoplasty 5 , 6 , 10 , 11 , 16 , 19 at a rate of 53%–66%, with marked frequency at the C2–3 level. 5 , 6 , 10 , 11 , 16 Postoperative interlaminar

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Paul G. Matz, Paul A. Anderson, Michael W. Groff, Robert F. Heary, Langston T. Holly, Michael G. Kaiser, Praveen V. Mummaneni, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic, and Daniel K. Resnick

Recommendations Indications: Cervical Spondylotic Myelopathy and OPLL Cervical laminoplasty is recommended in the treatment of myelopathy in the setting of CSM or OPLL. Using the JOA scale, ~ 55–60% recovery rate is anticipated (quality of evidence, Class III; strength of recommendation, D). The functional improvement observed after laminoplasty may be limited by duration of symptoms, severity of stenosis, severity of myelopathy, and poorly controlled diabetes as risk factors. There is conflicting evidence regarding age with 1 study citing age as a

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Kazuhiro Yamanaka, Toshiya Tachibana, Tokuhide Moriyama, Fumiaki Okada, Keishi Maruo, Shinichi Inoue, Yutaka Horinouchi, and Shinichi Yoshiya

reduction and fusion with instrumentation concomitant with laminoplasty for cervical myelopathy patients presenting with cervical spondylolisthesis or cervical kyphosis. Among the complications following cervical laminoplasty is fifth cervical nerve root palsy, which has been reported as one of the most frequently encountered problems. 2 , 3 , 8 , 10–12 , 14 , 15 , 18 , 19 In our experience, C-5 palsy occurs after laminoplasty more often when the procedure is combined with posterior spinal fusion. We hypothesized that concomitant reduction of kyphosis or

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Takeo Goto, Kenji Ohata, Toshihiro Takami, Misao Nishikawa, Naohiro Tsuyuguchi, Michiharu Morino, Yasuhiro Matusaka, Akimasa Nishio, Yuichi Inoue, and Mitsuhiro Hara

T o avoid the possible disadvantages of cervical laminectomy, 3, 6, 8, 10–12, 16, 25, 36 several authors have recently described various cervical laminoplasty techniques, including open-door laminoplasty, tension-band laminoplasty, suspension laminotomy, and double-door laminoplasty. 14, 15, 25, 29, 33 We describe a new laminoplasty technique involving the placement of porous HA laminar spacers and malleable titanium miniplates. The posterior elements of cervical spinal column are stabilized in a “lift-up” position. This technique can be used for all

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June Yoshii and Vincent C. Traynelis

laminae to open as a door. Patients who present with symptomatic multilevel cervical stenosis, no evidence of instability on flexion/extension views, and neutral or lordotic alignment of the cervical spine have been reported to benefit from laminoplasty at 10-year follow-up. 11 Laminoplasty may be advantageous for patients with achondroplasia and symptomatic cervical stenosis despite the anatomical characteristics of the achondroplastic cervical spine. To our knowledge, the present work describes the first case of cervical laminoplasty in an adult with achondroplasia

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Tetsuhiro Iguchi, Aritetsu Kanemura, Akira Kurihara, Koichi Kasahara, Shinichi Yoshiya, Minoru Doita, and Kotaro Nishida

newly enlarged spinal canal can consistently promote rigid bone bonding with low osteogenic activity. 8, 14, 17 The purpose of this study was to examine the clinical outcome in patients undergoing laminoplasty involving the use of high-porosity HA spacers, which has higher osteoconductive activity, 18, 19 and to assess its usefulness for cervical laminoplasty. Clinical Material and Methods Patient Population Between January 1997 and February 2001, 37 consecutive patients in whom no previous spinal surgery had been performed were treated at the lead author