Abstract
Anterior decompression at multiple disc spaces, multilevel corpectomy, laminectomy with or without fusion, and laminoplasty have all been performed to treat cervical diseases such as the ossification of the posterior longitudinal ligament (OPLL) and the cervical spondylotic myelopathy (CSM). Laminectomy has been the most used technique to decompress spinal cord in such conditions. Nonetheless spinal deformity, instability, progressive kyphotic deformity and late neurological deterioration are not infrequent complications after laminectomy. Laminoplasty techniques have been developed to overcome these problems but there are no definitive data supporting the superiority of laminoplasty over laminectomy in OPLL and CSM. Here we reviewed the available literature about laminoplasty, with particular attention to comparative works (laminoplasty vs laminectomy). We analyzed 38 articles. Twenty-three were papers reported the results of laminoplasty in OPLL and CSM, 7 articles compared two different types of laminoplasty technique and 8 studies were comparative works between laminoplasty and laminectomy. We found that laminoplasty was reported safe and effective in decompressing spinal cord, preserving the range of motion and the good clinical results at long follow-up. Moreover laminoplasty has been found to arrest the progression of myelopathy, also in elderly and debilitated patients, with low incidence of postoperative axial pain and kyphotic deformity at follow-up. Among different laminoplasty techniques the mini-plates fixation seems to provide the best results compared to suture fixation. Moreover most of comparative studies suggest that laminoplasty is associated with shorter hospital stay, greater functional improvement and with fewer late complications (including the need of further stabilization) compared to laminectomy. Nonetheless skip laminectomy seems a promising technique in terms of good results and low complications, although more comparative perspective studies are needed to confirm this evidence.