Multilevel cervical myelopathy treatment: open-door laminoplasty vs. multiple cervical arcocristectomies

Abstract

Purpose: Cervical myelopathy due to posterior multiple level compression remains a surgical challenger. Many surgical options have been used in the last years, but the best choice is unclear. We compared open-door laminoplasty and multiple level arcocristectomies on clinical and radiological findings. Methods: We retrospectively reviewed data from 36 patients, nineteen (52.77%) treated by ODL and seventeen (47.23%) by MLA between January 2008 and February 2014. Clinical findings were evaluated with Nurick scale. Canal diameter was evaluated with Magnetic Resonance Images (MRI). Results: Statistical analysis showed significant enlargement of the spinal canal for both ODL patients group and MLA patients group. They also revealed a significant improvement in the Nurick Scale grade when the preoperative value was compared with the immediate, 6 months and 12 months postoperative grades separately and together for both ODL patients group and MLA patients group. None significant statistical differences in clinical (Nurick grade scale) and radiological findings (MRI) was found between ODL and MLA groups, both in the first day (Nurick grade scale, p=0,48) or 6 months after the procedure (Nurick grade Scale, p=0,57; sagittal canal diameter on MRI, p=0,29) or 12 months of follow up (Nurick grade scale, p=0,29). Conclusion: Open door laminoplasty and multiple level arcocristectomies are good options to treat cervical myelophatic patients, with similar results regarding clinical and radiological findings.