Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 5, pp 611–616 | Cite as

Selective laminectomy for cervical spondylotic myelopathy: a comparative analysis with laminoplasty technique

  • Han Chang
  • Choll Kim
  • Byung-Wan Choi
Orthopaedic Surgery



The purpose of this study was to evaluate the effectiveness of selective laminectomy compared with laminoplasty for patients with multilevel cervical spondylotic myelopathy (CSM) by evaluating the radiological and clinical outcomes.


We retrospectively reviewed 67 patients with who underwent posterior laminectomy (LN) or laminoplasty (LP). LN was performed in 32 cases and LP in 35 cases. Radiologically, we evaluated the neutral C2–7 Cobb angle and range of motion (ROM) preoperatively and at final follow-up. Preoperative spinal cord compression and expansion of the spinal cord area postoperatively was evaluated using MRI. Differences in operating time and intraoperative and postoperative bleeding were analyzed. The clinical outcome was analyzed using the neck disability index (NDI) and the visual analog scale (VAS) for neck pain.


Surgery was performed on 2.04 segments in the LN group and 4.06 in the LP group. Cobb angle and ROM significantly decreased in the LN group at the final follow-up. No difference was found in the preoperative cord compression ratio or extent of expansion of the spinal cord postoperatively. The laminectomy group had a significantly shorter operation time and less intraoperative and postoperative bleeding. Both groups showed improved NDI, JOA score, and VAS for neck pain after surgery, with no significant differences.


Selective posterior laminectomy for the treatment of multilevel CSM showed advantages of shorter operation time and less blood loss, without a significant difference in clinical outcome, when compared with laminoplasty. However, postoperative kyphosis and decreased range of motion were limitations of laminectomy.


CSM Posterior Laminectomy Laminoplasty Kyphosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


This work was supported by a grant from Research year of Inje University in 2016.

Ethical approval

Institutional Review Board approval was obtained for this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Denaro V, Di Martino A (2011) A cervical spine surgery: an historical perspective. Clin Orthop Relat Res 469:639–648CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Rhee JM, Basra S (2008) Posterior surgery for cervical myelopathy: laminectomy, laminectomy with fusion, and laminoplasty. Asian Spine J 2:114–126CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Kaptain GJ, Simmons NE, Replogle RE, Pobereskin L (2000) Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg 93:199–204CrossRefPubMedGoogle Scholar
  4. 4.
    Satomi K, Nishu Y, Kohno T, Hirabayashi K (1994) Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine (Phila Pa 1976) 19:507–510CrossRefGoogle Scholar
  5. 5.
    Lee SE, Chung CK, Jahng TA, Kim HJ (2013) Long-term outcome of laminectomy for cervical ossification of the posterior longitudinal ligament. J Neurosurg Spine 18(5):465–471CrossRefPubMedGoogle Scholar
  6. 6.
    Bartels RH, van Tulder MW, Moojen WA, Arts MP, Peul WC (2015) Laminoplasty and laminectomy for cervical spondylotic myelopathy: a systematic review. Eur Spine J 24:160–167CrossRefPubMedGoogle Scholar
  7. 7.
    Lao L, Zhong G, Li X, Qian L, Liu Z (2013) Laminoplasty versus laminectomy for multi-level cervical spondylotic myelopathy: a systematic review of the literature. J Orthop Surg Res 8:45CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Tsuji T, Asazuma T, Masuoka K, Yasuoka H, Motosuneya T, Sakai T, Nemoto K (2007) Retrospective cohort study between selective and standard C3–7 laminoplasty. Minimum 2-year follow-up study. Eur Spine J 16:2072–2077CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Hirabayashi K, Satomi K (1988) Operative procedure and results of expansive open-door laminoplasty. Spine (Phila Pa 1976) 13:870–876CrossRefGoogle Scholar
  10. 10.
    Song KJ, Choi BW, Kim JK (2014) Adjacent segment pathology following anterior decompression and fusion using cage and plate for the treatment of degenerative cervical spinal diseases. Asian Spine J 8:720–728CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Pal GP, Sherk HH (1998) The vertical stability of the cervical spine. Spine (Phila Pa 1976) 13:447–449CrossRefGoogle Scholar
  12. 12.
    Panjabi MM, Summers DJ, Pelker RR, Videman T, Friedlaender GE, Southwick WO (1986) Three-dimensional load-displacement curves due to forces on the cervical spine. J Orthop Res 4:152–161CrossRefPubMedGoogle Scholar
  13. 13.
    Kato Y, Iwasaki M, Fuji T, Yonenobu K, Ochi T (1998) Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament. J Neurosurg 89:217–223CrossRefPubMedGoogle Scholar
  14. 14.
    Kode S, Kallemeyn NA, Smucker JD, Fredericks DC, Grosland NM (2014) The effect of multi-level laminoplasty and laminectomy on the biomechanics of the cervical spine: a finite element study. Iowa Orthop J 34:150–157PubMedPubMedCentralGoogle Scholar
  15. 15.
    Takahashi Y, Narusawa K, Shimizu K, Hijioka A, Nakamura T (2006) Enlargement of cervical spinal cord correlates with improvement of motor function in upper extremities after laminoplasty for cervical myelopathy. J Spinal Disord Tech 19:194–198CrossRefPubMedGoogle Scholar
  16. 16.
    Lee CH, Jahng TA, Hyun SJ, Kim KJ, Kim HJ (2016) Expansive laminoplasty versus laminectomy alone versus laminectomy and fusion for cervical ossification of the posterior longitudinal ligament: is there a difference in the clinical outcome and sagittal alignment? Clin Spine Surg 29(1):E9–E15PubMedGoogle Scholar
  17. 17.
    Hatta Y, Shiraishi T, Hase H, Yato Y, Ueda S, Mikami Y, Harada T, Ikeda T, Kubo T (2005) Is posterior spinal cord shifting by extensive posterior decompression clinically significant for multisegmental cervical spondylotic myelopathy? Spine (Phila Pa 1976) 30:2414–2419CrossRefGoogle Scholar
  18. 18.
    Denaro V, Longo UG, Berton A, Salvatore G, Denaro L (2015) Cervical spondylotic myelopathy: the relevance of the spinal cord back shift after posterior multilevel decompression. A systematic review. Eur Spine J 24:832–841CrossRefPubMedGoogle Scholar
  19. 19.
    Lee DH, Park SA, Kim NH, Hwang CJ, Kim YT, Lee CS, Riew KD (2011) Laminar closure after classic Hirabayashi open-door laminoplasty. Spine (Phila Pa 1976) 36(25):E1634–1640CrossRefGoogle Scholar
  20. 20.
    Liu G, Buchowski JM, Riew KD (2015) Screw back-out following “Open-Door” cervical laminoplasty: a review of 165 plates. Asian Spine J 9:849–854CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Hatta Y, Shiraishi T, Hase H, Yato Y, Ueda S, Mikami Y, Harada T, Ikeda T, Kubo T (2005) Is posterior spinal cord shifting by extensive posterior decompression clinically significant for multisegmental cervical spondylotic myelopathy? Spine (Phila Pa 1976) 30(21):2414–2419CrossRefGoogle Scholar
  22. 22.
    Zhao X, Xue Y, Pan F, Zhao H, Li P, Wang P, Ma X (2012) Extensive laminectomy for the treatment of ossification of the posterior longitudinal ligament in the cervical spine. Arch Orthop Trauma Surg 132:203–209CrossRefPubMedGoogle Scholar
  23. 23.
    Shiraishi T (2002) Skip laminectomy—a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report. Spine J 2:108–115CrossRefPubMedGoogle Scholar
  24. 24.
    Shiraishi T, Kato M, Yato Y, Ueda S, Aoyama R, Yamane J, Kitamura K (2012) New techniques for exposure of posterior cervical spine through intermuscular planes and their surgical application. Spine (Phila Pa 1976) 37(5):E286–296CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryBusan Korea HospitalBusanRepublic of Korea
  2. 2.Department of Orthopedic Surgery, Haeundae Paik HospitalInje UniversityBusanRepublic of Korea

Personalised recommendations