Multifactor Analysis on the Outcomes of Cervical Spondylotic Myelopathy with Expansive Open-Door Laminoplasty

Abstract

OBJECTIVES: To examine clinical outcomes following expansive open-door laminoplasty (EOLP) in the treatment of multilevel cervical spondylotic myelopathy (CSM) and the factors that influence these outcomes. METHODS: This retrospective analysis in CSM patients following EOLP investigated the relationship between recovery rate, based on the Japanese Orthopaedic Association (JOA) score, and the impact of age, duration of CSM, and axial symptoms, including the effect of EOLP on cervical curvature. RESULTS: In total, 79 CSM patients were included. Overall, the pre-and postoperative (1 year after surgery) mean ± SD JOA scores were 9.6 ± 1.4 and 14.7 ± 1.9, respectively, indicating an improvement of 68.9%. Factors that were significantly related to ‘excellent’ (≥ 75%) or ‘good’ (≥ 50% – < 75%) recovery rates included a high preoperative JOA score, short duration of CSM (≤ 12 months) and patient age < 50 years. Significant reductions in cervical curvature angle were only observed in patients with axial symptoms. CONCLUSIONS: These results indicate that CSM should be treated early. The severity of CSM, the patient's age, cervical curvature angle, operation technique and axial symptoms play important roles in clinical outcomes.