Concepts of Posterior Decompressive Surgery



Countries in East Asia have a high prevalence of myelopathy related to ossification of the posterior longitudinal ligament (OPLL). Due to an ossified ligamentous compression of the spinal cord from anterior, progressive cervical myelopathy results in a high level of disability. In the 1960s, cervical laminectomy that completely removes laminae with attached ligamentous structures was the only available surgical procedure for cervical myelopathy. Decompression was achieved with a posterior shift of the spinal cord by removing posterior elements of the cervical spine. However, the surgical outcomes were rather unpredictable due to various complications, such as iatrogenic spinal cord injury and recurrent myelopathy caused by the epidural scar formation or development of postoperative kyphosis.


  1. 1.
    Chiba K, Ogawa Y, Ishii K, Takaishi H, Nakamura M, Maruiwa H, Matsumoto M, Toyama Y. Long-term results of expansive open-door laminoplasty for cervical myelopathy—average 14-year follow-up study. Spine (Phila Pa 1976). 2006;31(26):2998–3005.CrossRefGoogle Scholar
  2. 2.
    Nori S, Shiraishi T, Aoyama R, et al. Muscle-preserving selective laminectomy maintained the compensatory mechanism of cervical lordosis after surgery. Spine (Phila Pa 1976). 2018;43:542.CrossRefGoogle Scholar
  3. 3.
    Yuan W, Zhu Y, Liu X, Zhou X, Cui C. Laminoplasty versus skip laminectomy for the treatment of multilevel cervical spondylotic myelopathy: a systematic review. Arch Orthop Trauma Surg. 2014;134(1):1–7.CrossRefGoogle Scholar
  4. 4.
    Phan K, Scherman DB, Xu J, Leung V, Virk S, Mobbs RJ. Laminectomy and fusion vs laminoplasty for multi-level cervical myelopathy: a systematic review and meta-analysis. Eur Spine J. 2017;26(1):94–103.CrossRefGoogle Scholar
  5. 5.
    Vidal PM, Karadimas SK, Ulndreaj A, Laliberte AM, Tetreault L, Forner S, Wang J, Foltz WD, Fehlings MG. Delayed decompression exacerbates ischemia-reperfusion injury in cervical compressive myelopathy. JCI Insight. 2017;2(11):92512.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, School of MedicineInternational University of Health and Welfare (IUHW)OtawaraJapan
  2. 2.Department of Orthopaedic SurgeryTokyo Dental College Ichikawa General HospitalIchikawaJapan

Personalised recommendations