Journal of Neurology

, Volume 243, Issue 9, pp 626–632 | Cite as

Lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy: A magnetic resonance imaging study

  • Hisatoshi Baba
  • Kenzo Uchida
  • Yasuhisa Maezawa
  • Nobuaki Furusawa
  • Miki Azuchi
  • Shinichi Imura
Original Communication


We investigated lordotic alignment and posterior migration of the spinal cord following en bloc open-door laminoplasty for cervical myelopathy. Fifty-five patients (32 men and 23 women) were studied, with an average follow-up of 2.4 years. Radiological examination included evaluation of lordosis of the cervical spine and spinal cord, degree of enlargement of bony spinal canal, and the magnitude of posterior cord migration. We also correlated these changes with neurological improvement. Postoperatively, there was an average of 5% loss of cervical spine lordosis (P > 0.01) on radiographs and 12% reduction in the lordotic alignment of the spinal cord (P > 0.05) on magnetic resonance imaging. Postoperatively, the size of the bony spinal canal increased by 48%. Posterior cord migration showed a significant correlation with the preoperative cervical spine and spinal cord lordosis (P < 0.05). Thirty-seven (67%) patients with neurological improvement exceeding 50% showed significant posterior cord migration following laminoplasty compared with those demonstrating less than 50% improvement (P = 0.01). Our results suggest that a significant neurological improvement is associated with posterior cord migration after cervical laminoplasty.

Key words

Magnetic resonance imaging Cervical laminoplasty Spinal cord Lordosis 


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  1. 1.
    Aboulker J, Metzger J, David M, Engel P, Ballivet J (1965) Les myélopathies cervicales d'origine rachidienne. Neurochirurgie 11: 87–198Google Scholar
  2. 2.
    Adams CBT, Logue V (1971) Studies in cervical spondylotic myelopathy. II. The movement and contour of the spine in relation to the neural complications of cervical spondylosis. Brain 94: 569–586Google Scholar
  3. 3.
    Baba H, Furusawa N, Imura S, Kawahara N, Tsuchiya H, Tomita K (1993) Late radiographic findings after anterior cervical fusion for spondylotic mycloradiculopathy. Spine 18: 2167–2173Google Scholar
  4. 4.
    Baba H, Furusawa N, Chen Q, Imura S (1995) Cervical laminoplasty in patients with ossification of the posterior longitudinal ligaments. Paraplegia 33: 25–29Google Scholar
  5. 5.
    Baba H, Imura S, Kawahara N, Nagata S, Tomita K (1995) Osteoplastic laminoplasty for cervical myeloradiculopathy secondary to ossification of the posterior longitudinal ligament. Int Orthop 19: 40–45Google Scholar
  6. 6.
    Baba H, Maezawa Y, Furusawa N, Imura S, Tomita K (1995) Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy: a radiographic study. Int Orthop 19: 116–121Google Scholar
  7. 7.
    Baba H, Chen Q, Uchida K, Imura S, Morikawa S, Tomita K (1996) Laminoplasty with foraminotomy for coexisting cervical myelopathy and unilateral radiculopathy: a preliminary report. Spine 21: 196–202Google Scholar
  8. 8.
    Batzdorf U, Batzdorff A (1988) Analysis of cervical spine curvature in patients with cervical spondylosis. Neurosurgery 22: 827–836Google Scholar
  9. 9.
    Batzdorf U, Flannigan BD (1991) Surgical decompressive procedures for cervical spondylotic myelopathy: a study using magnetic resonance imaging study. Spine 16: 123–127Google Scholar
  10. 10.
    Epstein N (1993) The surgical management of ossification of the posterior longitudinal ligament in 51 patients. J Spinal Disord 6: 432–455Google Scholar
  11. 11.
    Faccioli F, Buffatti P, Grosslercher JC, Bricolo A, Dalle-Ore G (1988) Laminotomie cervicale decompressive a “porte ouverte”. Technique et premieres experiences. Neurochirurgie 33: 38–43Google Scholar
  12. 12.
    Frank E, Keenen TL (1994) A technique for cervical laminoplasty using mini plates. Br J Neurosurg 8: 197–199Google Scholar
  13. 13.
    Herkowitz HN (1988) A comparison of anterior cervical fusion, cervical laminectomy, and cervical laminoplasty for the surgical management of multiple level spondylotic radiculopathy. Spine 13: 774–780Google Scholar
  14. 14.
    Herkowitz HN (1988) Cervical laminaplasty: its role in the treatment of cervical radiculopathy. J Spinal Disord 1: 179–188Google Scholar
  15. 15.
    Herkowitz HN (1989) The surgical management of cervical spondylotic radiculopathy and myelopathy. Clin Orthop 239: 94–108Google Scholar
  16. 16.
    Hukuda S, Ogata M, Mochizuki T, Schchikawa K (1988) Laminectomy versus laminoplasty for cervical myelopathy: brief report. J Bone Joint Surg [Br] 70: 325–326Google Scholar
  17. 17.
    Japanese Orthopaedic Association (1976) Criteria for the evaluation of treatment of cervical myelopathy. J Jpn Orthop Assoc (Tokyo) 49: addendum no. 5Google Scholar
  18. 18.
    Kawai S (1991) Cervical laminoplasty. In: Bridwell KH, DeWald RH (eds) The textbook of spinal surgery, vol 2. Lippincott, Philadelphia, pp 805–812Google Scholar
  19. 19.
    Levi L, Wolf A, Mirvis S, Rigamonti D, Fianfaca MS, Monâsky M (1995) The significance of dorsal migration of the cord after extensive cervical laminectomy for patients with traumatic central cord syndrome. J Spinal Disord 8: 289–295Google Scholar
  20. 20.
    Matsuyama Y, Kawakami N, Mimatsu K (1995) Spinal cord expansion after decompression in cervical myelopathy: investigation by computed tomography myelography and ultrasonography. Spine 20: 1657–1663Google Scholar
  21. 21.
    Mehalic TF, Pezzuti RT, Applebaum BI (1990) Magnetic resonance imaging and cervical spondylotic myelopathy. Neurosurgery 26: 217–227Google Scholar
  22. 22.
    Nowinski GP, Visarius H, Nolte LP, Herkowitz HN (1993) A biomechanical comparison of cervical laminaplasty and cervical laminectomy with progressive facetectomy. Spine 18: 1995–2004Google Scholar
  23. 23.
    Okada Y, Ikata T, Yamada H, Sakamoto R, Kato S (1993) Magnetic resonance imaging study on the results of surgery for cervical compression myelopathy. Spine 18: 2024–2029Google Scholar
  24. 24.
    Raynor RB, Moskovich R, Zidel P, Pugh J (1987) Alteration in primary and coupled neck motions after facetectomy. Neurosurgery 21: 681–687Google Scholar
  25. 25.
    Scoville WB (1961) Cervical spondylosis treatment by facetectomy and laminectomy. J Neurosurg 18: 423–428Google Scholar
  26. 26.
    Skowronski J, Bielecki M (1992) The results of laminectomy and laminoplasty in cervical myeloradiculopathy. Rocz Akad Med Bialymst 37: 71–73Google Scholar
  27. 27.
    Transfeldt EE (1991) Cervical spondylosis. In: Bridwell KH, DeWald RL (eds) The textbook of spinal surgery. Lippincott, Philadelphia, pp 771–804Google Scholar
  28. 28.
    White AA IIIrd, Panjabi MM (1988) Biomechanical considerations in the surgical management of cervical spondylotic myelopathy. Spine 13: 850–856Google Scholar
  29. 29.
    Yone K, Sakou T, Yanase M, Ijiri K (1992) Preoperative and postoperative magnetic resonance image evaluations of the spinal cord in cervical myelopathy. Spine 17: 5388–5392Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Hisatoshi Baba
    • 1
  • Kenzo Uchida
    • 1
  • Yasuhisa Maezawa
    • 1
  • Nobuaki Furusawa
    • 1
  • Miki Azuchi
    • 1
  • Shinichi Imura
    • 1
  1. 1.Department of Orthopaedic SurgeryFukui Medical SchoolMatsuoka, FukuiJapan

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