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Spine (Phila Pa 1976). 2009 Dec 1;34(25):2760-8. doi: 10.1097/BRS.0b013e3181b11ee1.

Revision surgery following cervical laminoplasty: etiology and treatment strategies.

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  • 1Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO 63110, USA.

Abstract

STUDY DESIGN:

Retrospective review of prospectively collected data.

OBJECTIVE:

To identify the cause of failed open-door laminoplasty and to describe the surgical strategies for revision surgery.

SUMMARY OF BACKGROUND DATA:

Although laminoplasty has become popular, few articles have addressed the cause of failed cervical laminoplasty requiring revision surgery.

METHODS:

All patients who required revision surgery following open-door cervical laminoplasty were identified. Clinical data, method of surgical revision, time between surgeries, Nurick grade, radiologic parameters, and complications were analyzed. Laminoplasty failures were classified into 3 categories: "technique related," "inadequate symptomatic relief after treatment," or "recurrence of symptoms due to disease progression."

RESULTS:

A total of 130 patients underwent cervical laminoplasty over a 10-year period (1996-2006), and 12 patients (9.2%) required revision surgery. The mean age was 50.7 years at the time of the index laminoplasty (range, 34-67 years) and 51.8 years (range, 35-70 years) at the time of the revision surgery. Mean duration of symptoms was 7.3 months before the index procedure (range, 2-17 months) and 5.6 months (range, 1-14 months) before revision surgery. The mean time interval between the index procedure and revision surgery was 16.6 months (range, 4-43 months). Of the 12 patients who required revision surgery, 5 had global lordosis of <10 degrees, 4 developed local kyphosis >13 degrees, and 5 had increased degenerative spondylolisthesis. Nonmyelopathic causes resulted in 50% of the revision surgery. Of 12 patients, 3 (25%) required revision surgery due to technique-related factors; 1 (8%) required surgery due to inadequate symptomatic relief after treatment; and 8 (67%) required revision surgery due to disease progression.

CONCLUSION:

Of the 130 patients who underwent cervical laminoplasty over a 10-year period, 12 patients (9.2%) required revision surgery. Although laminoplasty is generally successful, failures due to disease progression, technique-related factors, and inadequate symptomatic relief after treatment can occur. Patients should, therefore, be counseled regarding the potential need for revision surgery when undergoing open-door laminoplasty.

PMID:
19940734
[PubMed - indexed for MEDLINE]
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