Modified open-door laminoplasty for the surgical treatment of cervical spondylotic myelopathy in elderly patients.

Abstract

The authors describe their experience with a modified version of the standard technique of open-door laminoplasty for the surgical treatment of spondylotic myelopathy in elderly patients with temporary removal of the laminae, extensive decompression, and pre-plating of the laminae beyond the surgical field. Description of surgical anatomy, surgical technique, indications, limitations, complications, and specific perioperative considerations, as well as specific information to give to the patient about surgery and potential risks. A summary of ten key points is given. Transection of the laminae on both sides (temporary laminectomy) and pre-plating of the laminae outside of the surgical field has several advantages: better decompression of the spinal canal and the neuroforamina on both sides, easier undercutting of adjacent vertebral arches for cranio-caudal decompression, and no risk of spinal cord injury by the screwdriver when attaching plates to the laminae.