S-Space College of Medicine/School of Medicine (의과대학/대학원) Orthopedic Surgery (정형외과학전공) Journal Papers (저널논문_정형외과학전공)
Revision Surgery Following Cervical Laminoplasty Etiology and Treatment Strategies
- Liu, Gabriel; Buchowski, Jacob M.; Bunmaprasert, Torphong; Yeom, Jin S.; Shen, Hongxing; Riew, K. Daniel
- Issue Date
- LIPPINCOTT WILLIAMS & WILKINS
- SPINE Vol.34 No.25, pp. 2760-2768
- Study Design. Retrospective review of prospectively
Objective. To identify the cause of failed open-door
laminoplasty and to describe the surgical strategies for
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°, 4 developed local kyphosis 13°, 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.
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