The Surgical Management of Cervical Myelopathy—A Perspective from Asia Pacific

  • Thanh Van VoEmail author
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 63)


The cervical myelopathy is currently more frequent in Asia Pacific including Vietnam. The diagnosis is based mainly on clinical examination combined with scrutiny investigation for the detection of different compressive etiologies. The surgical management for serious compressive cervical myelopathy is often realized with rigorous indication in practicing different techniques adapting to the current situation of the patients and multi-various factor. The cervical laminoplasty was recognized and realized safely by laminoplasty for multiple level, with little or without cervical kyphosis. The alternative technique modified Hirabayashi laminoplasty with wiring from tips of spinous processes to the lateral mass screws has been practiced in Vietnam since 2003. The Tateru Shiraishi cervical laminoplsty with preservation of deep extensors and rotators-posterior cervical complex have been practiced since 2002 in showing the least muscular destruction and fibrous degeneration. It also improves the axial pain frequently seen with the classical Kurokawa or Itoh technique, currently applied in Japan.


Cervical myelopathy Cervical disc herniation (CDH) Cervical spinal spondylosis (CSS) Ossification of posterior longitudinal ligamenet (OPLL) Ossification of yellow ligament (OYL) 


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  1. 1.
    Albert T, Vacarro A (1998) Postlaminectomy kyphosis. Spine 23:2738–2745CrossRefGoogle Scholar
  2. 2.
    Baba H, Furusawa N, Imura S et al (1993) Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy. Spine 18:2167–2173CrossRefGoogle Scholar
  3. 3.
    Bell DF, Walker JL, O’Connor G et al (1994) Spinal deformity after multiple-level cervical laminectomy in children. Spine 19:406–411CrossRefGoogle Scholar
  4. 4.
    Butler JC, Whitecloud TD (1992) Postlaminectomy kyphosis. Causes and surgical management. Orthop Clin North Am 23:505–511Google Scholar
  5. 5.
    Callahan R, Johnson R, Margolis R et al (1977) Cervical facet fusion for control of instability following laminectomy. J Bone Joint Surg 59A:991–1002CrossRefGoogle Scholar
  6. 6.
    Catell S, Clark L (1967) Cervical kyphosis and instability following multiple laminectomies in children. J Bone Joint Surg 49A:713–720CrossRefGoogle Scholar
  7. 7.
    Chiba K, Toyama Y, Matsumoto M, Maruiwa H, Watanabe M; Hirabayashi K (2002) Segmental motor paralysis after expansive open- door laminoplasty. Spine 27(19):2108–2115Google Scholar
  8. 8.
    Clarke E, Robinson PK (1956) Cervical myelopathy. A complication of cervical spondylosis. Brain 79:483–510Google Scholar
  9. 9.
    Cloward RB (1958) The anterior approach for removal of ruptured cervical discs. J Neurosurg 15:602–614CrossRefGoogle Scholar
  10. 10.
    Daftari TK, Herkowitz HN (1998) Open door laminaplasty. Posterior cervical spine surgery. Principles and techniques in spine surgery. Lippincott, Raven, 161–170Google Scholar
  11. 11.
    Epstein J, Epstein N (1994) Laminectomy for spondylotic myelopathy and radiculopathy. In: Sherk HH (ed) The cervical spine. An atlas of surgical procedures. Lippincott, Philadelphia, pp 219–232Google Scholar
  12. 12.
    Guigui P, Benoist M, Deburge A (1998) Spinal deformity and instability after multilevel cervical laminectomy for spondylotic myelopathy. Spine 23:440–447CrossRefGoogle Scholar
  13. 13.
    Hirabayashi K, Bohlman HH (1995) Multiple cervical spondylosis. Laminoplasty versus anterior decompression. Spine 20:1732–1734CrossRefGoogle Scholar
  14. 14.
    Hirabayashi K, Watanabe K, Wakano K et al (1983) Expansive open-door laminoplasty for cervical spinal stenotic myelopathy. Spine 8:693–699CrossRefGoogle Scholar
  15. 15.
    Hirabayashi K, Miyakawa J, Satomi K et al (1981) Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligaments. Spine 6:354–364CrossRefGoogle Scholar
  16. 16.
    Hirabayashi K, Yoshiki T, Kazuhiro C (1999) Expansive laminoplasty for myelopathy in ossification of the longitudinal ligament. Clin Orthopedics Related Res 1(359):35–48Google Scholar
  17. 17.
    Hirabayashi K, Satomi K (1988) Operative procedure and results of expansive opendoor laminoplasty. Spine 13:870–876CrossRefGoogle Scholar
  18. 18.
    Herkowitz HN, Kurz LT, Overholt DP (1990) Surgical management of cervical soft disc herniation: a comparison between the anterior and posterior approach. Spine 15:1026–1030CrossRefGoogle Scholar
  19. 19.
    Herkowitz H (1988) A comparison of anterior cervical fusion, cervical laminectomy, and cervicallaminoplasty for the surgical management of multiple-level spondylotic radiculopathy. Spine 13:774–780CrossRefGoogle Scholar
  20. 20.
    Hosono N, Yonenobu K, Ono K (1996) Neck and shoulder pain after laminoplasty. A noticeable complication. Spine 21:1969–1973CrossRefGoogle Scholar
  21. 21.
    Itoh T, Tsuji H (1985) Technical improvement and results of laminoplasty for compressive myelopathy in the cervical spine. Spine 10:729–736CrossRefGoogle Scholar
  22. 22.
    Itoh T (1998) En bloc laminalasty. Posterior cervical spine surgery. Principles and techniques in spine surgery. Lippincott, Raven, pp 171–187Google Scholar
  23. 23.
    Ishida Y, Suzuki K, Ohmori K et al (1989) Critical analysis of extensive cervical laminectomy. Neurosurgery 24:215–222CrossRefGoogle Scholar
  24. 24.
    Kamioka Y, Yamamoto H, Tani T et al (1989) Postoperative instability of cervical OPLL and cervical radiculomyelopathy. Spine 14:1177–1183CrossRefGoogle Scholar
  25. 25.
    Katsumi Y, Honma T, Nakamura T (1989) Analysis of cervical instability resulting from laminectomies for removal of spinal cord tumor. Spine 14:1171–1176CrossRefGoogle Scholar
  26. 26.
    Kawai S, Sunago K, Doi M et al (1988) Cervical laminoplasty (Hattori’s method). Procedure and follow-up results. Spine 13:1245–1250Google Scholar
  27. 27.
    Kokubun S, Sato T (1998) Cervical myelopathy and its management. Curr Orthop 12:7–12CrossRefGoogle Scholar
  28. 28.
    Kokubun S, Sato T, Ishii Y, Tanaka Y (1996) Cervical myelopathy in the Japanese. Clin Orthop 323:129–138CrossRefGoogle Scholar
  29. 29.
    Mayfield FH (1965) Cervical spondylosis: a comparison of anterior and posterior approaches. Clin Neurosurg 13:181–188Google Scholar
  30. 30.
    Mikawa Y, Shikata J, Yamamuro T (1987) Spinal deformity and instability after multilevel cervical laminectomy. Spine 3:6–11CrossRefGoogle Scholar
  31. 31.
    Miyazaki K, Tada K, Matsuda Y et al (1989) Posterior extensive simultaneous multisegmental decompression with posterolateral fusion for cervical myelopathy with cervical instability and kyphotic and/or S-shaped deformities. Spine 14:1161–1170CrossRefGoogle Scholar
  32. 32.
    Nowinski GP, Visarius H, Nolte LP et al (1993) A biomechanical comparison of cervical laminoplasty and cervical laminectomy with progressive facetectomy. Spine 14:1995–2004CrossRefGoogle Scholar
  33. 33.
    Robinson RA, Smith G (1955) Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Med J 96:223–224Google Scholar
  34. 34.
    Sim FH, Suien HJ, Bickel WH et al (1974) Swan-neck deformity following extensive cervical laminectomy. J Bone Joint Surg 56A:564–580CrossRefGoogle Scholar
  35. 35.
    Smith GW, Robinson RA (1958) The treatment of certain cervical spine disorders by the anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg 40A:607–624CrossRefGoogle Scholar
  36. 36.
    Raynor RB, Pugh J, Shapiro I (1985) Cervical facetectomy and its effect on spine strength. J Neurosurg 63:278–282CrossRefGoogle Scholar
  37. 37.
    Raynor RB (1998) Laminectomy for cervical spondylosis: indications and techniques. In: Ono K, Dvorak J, Dunn E (eds) Cervical spondylosis and similar disorders. World Scientific, Singapore, pp 477–499CrossRefGoogle Scholar
  38. 38.
    Satomi K, Nishi Y, Kohno T et al (1994) Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine 19:507–510CrossRefGoogle Scholar
  39. 39.
    Seichi A, Takeshita K, Nakamura K et al (2001) Long-term results of double-door laminoplasty for cervical stenotic myelopathy. Spine 26:479–487CrossRefGoogle Scholar
  40. 40.
    Shiraishi T (2002), A new technique for exposure of the cervical spine laminae, J Neurosurg (Spine 1) 96:122–126Google Scholar
  41. 41.
    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 2:108–115CrossRefGoogle Scholar
  42. 42.
    Shiraishi T (2003), Results of skip laminectomy—minimum 2-year follow-up study compared with open-door laminoplasty. Spine 28(24):2667–2672Google Scholar
  43. 43.
    Shiraishi T (2012), New techniques for exposure of posterior cervical spine through intermuscular planes and their surgical application. Spine 37(5):E286–E296Google Scholar
  44. 44.
    Thanh VV et al (1997) Case report. a case involving in cervical myelopathy due to ossification of posterior longitudinal ligament. Scientific papers 1997. University of Medicine and Pharmacy, pp 204–208Google Scholar
  45. 45.
    Thanh VV et al (1997) Laminoplasty—first experiences on the management of cervical myelopathy due to cervical spinal stenosis by Kurokawa Laminoplasty. HCMC J Med 1(Supplementary N. 4):55–60Google Scholar
  46. 46.
    Wang JM, Roh K-J, Kim DJ, Kim DW (1998) A new method of stabilizing the elevated laminae in open door laminoplasty using the anchor system. J Bone Joint Surg [Br] 80-B:1005–1008Google Scholar
  47. 47.
    Yonenobu K, Okada K, Fuji T et al (1986) Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine 11:818–823CrossRefGoogle Scholar
  48. 48.
    Yonenobu K, Hosono N, Iwasaki M et al (1992) Laminoplasty versus subtotal corpectomy: a comparative study of results in multisegmental cervical spondylotic myelopathy. Spine 17:1281–1284CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Pham Ngoc Thach Medical FacultyHo Chi Minh CityVietnam

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