Upper adjacent segment disease following cervical laminoplasty: Report of two cases and a literature review

Abstract

Adjacent segment disease is a well-recognized adverse event developing after spinal fusion surgery. However, there are few reports evaluating adjacent segment disease following cervical laminoplasty because of the advantage of laminoplasty in preserving mobility of the treated segments. We report two cases of adjacent-level segment disease following cervical laminoplasty.Case 1: An 89-year-old man who was performed C2/C7 partial laminectomy and C3–C6 laminoplasty 9 years earlier experienced walking disturbance. Neuroimaging revealed atlantoaxial dislocation, and he underwent C1–C2 posterior cervical spinal fusion, which improved his ambulatory status to baseline.Case 2: A 77-year-old man who was performed C2/C7 partial laminectomy and C3–C6 laminoplasty 12 years earlier presented with gait disturbance. Neuroimaging demonstrated severe spinal cord compression resulting from a retro-odontoid pseudotumor. Therefore, occipital bone–C2 posterior fusion was performed, which resulted in clinical improvement.Although adjacent segment disease following cervical laminoplasty is a rare complication, we should carefully follow patients postoperatively after cervical laminoplasty because compression of the upper spinal cord might cause severe neurological deficits.

Keywords

• Adjacent segment disease
• Retro-odontoid pseudotumor
• Atlanto-axial dislocation
• Cervical laminoplasty