Clinical and radiological outcomes of C3–C6 laminoplasty with C7 dome-like laminectomy

Abstract

Objective: The purpose of this study was to compare the surgical outcomes of C3–C6 laminoplasty and C3–C6 laminoplasty with C7 dome-like laminectomy for the treatment of patients with stenosis at the C6–7 level. Methods: Forty-nine patients who underwent C3–C6 laminoplasty and 39 patients who underwent C7 dome-like laminectomy were selected based on strict criteria, including the presence of stenosis grade 2 at the C6–7 level preoperatively. The clinical and radiologic outcomes were compared at admission and at 1 and 2 years postoperatively. Results: The baseline clinical characteristics did not differ significantly between the two groups. The Japanese Orthopedic Association score improved more significantly in the C7 dome-like laminectomy group (p = 0.01). There was no significant difference in neck pain between the two groups (p = 0.15). The spinal cord diameter at the C6–7 level was significantly increased in the dome-like laminectomy group (p = 0.01). There were no significant differences in the cross-sectional area of the paraspinal muscles, the cervical lordotic angle between C2–C7 and the cervical range of motion between the two groups (p = 0.33, 0.46, and 0.41, respectively). Neurological deterioration was not observed in C7 dome-like laminectomy group while 4 patients developed neurological deterioration in C3–C6 laminoplasty group. Conclusions: C7 dome-like laminectomy can be a surgical option for patients with stenosis grade 2 at the C6–7 level. It is possible to obtain adequate spinal cord decompression while obtaining good clinical and radiologic outcomes. Keywords: Cervical spine, C3–C6 laminoplasty, C3–C7 laminoplasty, C3–C6 laminoplasty with C7 dome-like laminectomy