Cervical laminoplasty in the neutral spine – A case report and literature review

Cervical spondylotic myelopathy is a common presentation to spinal surgeons. While laminectomy is routinely employed in multilevel disease the recognized complications include iatrogenic spinal cord injury, post-laminectomy kyphosis, and secondary neurological deterioration. Originally introduced in Japan in the 1980's, to manage the problem of posterior ossification of the posterior longitudinal ligament, the procedure now enjoys wider application including in the context of degenerative spine. The aims of laminoplasty are to expand the spinal canal, prevent scar formation over the dura, avoid destabilization, and preserve spinal mobility. While utilized extensively in patients with preserved cervical lordosis, the neutral spine and mildly kyphotic spine are regarded as relatively unsuitable for the procedure due poor clinical outcome and a high incidence of progressive kyphosis. We present a case report of 2 patients, one with preserved cervical kyphosis, and one with a neutral spine, in who we performed cervical laminoplasty. Through the 1-year follow-up result of our 2nd case report, were no progression of cervical kyphosis was demonstrated, we confirm that cervical laminoplasty can be used in patients with multi-level spinal stenosis and a neutral spine.