The role of laminoplasty in cervical spine diseases. Evidences from a literature review

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Nicola Montano Alessandro Izzo Cosimo Sturdà


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. 

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MONTANO, Nicola; IZZO, Alessandro; STURDÀ, Cosimo. The role of laminoplasty in cervical spine diseases. Evidences from a literature review. Medical Research Archives, [S.l.], v. 4, n. 6, oct. 2016. ISSN 2375-1924. Available at: <>. Date accessed: 25 june 2024.
Ossification of the posterior longitudinal ligament, cervical spondylotic myelopathy, laminoplasty, laminectomy
Review Articles


1. Asgari S, Bassiouni H, Massoud N, Schlamann M, Stolke D, Sandalcioglu IE. Decompressive laminoplasty in multisegmental cervical spondylotic myelopathy: bilateral cutting versus open-door technique. Acta Neurochir. 2009; 151:739–749
2. Chen G, Luo Z, Nalajala B, Liu T, Yang H. Expansive Open-door Laminoplasty With Titanium Miniplate Versus Sutures. Orthopedics. 2012; 35:e543-8
3. Chen H, Deng Y, Li T, Gong Q, Song Y, Liu H. Clinical and radiography results of mini-plate fixation compared tosuture suspensory fixation in cervical laminoplasty: A five-year follow-up study. Clin Neurol Neurosurg. 2015;138:188-95.
4. Chiba K, Ogawa Y, Ishii K, Takaishi H, Nakamura M, Maruiwa H, Matsumoto M, Toyama Y. Long-term results of expansive open-door laminoplasty for cervical myelopathy--average 14-year follow-up study. Spine (Phila Pa 1976). 2006;31(26):2998-3005.
5. Della Pepa GM, Roselli R, La Rocca G, Spallone A, Barbagallo G, Visocchi M. Laminoplasty is better of laminectomy in cervical stenotic myelopathy: myth or truth? Eur Rev Med Pharmacol Sci. 2014;18(1 Suppl):50-54.
6. Duetzmann S, Cole T, Ratliff JK. Cervical laminoplasty developments and trends, 2003-2013: a systematic review. J Neurosurg Spine. 2015;23(1):24-34
7. Edwards CC 2nd, Heller JG, Silcox DH 3rd. T-Saw Laminoplasty for the Management of Cervical Spondylotic Myelopathy Clinical and Radiographic Outcome. Spine (Phila Pa 1976). 2000;25(14):1788-94.
8. Goel VK, Clark CR, Harris KG, Schulte KR. Kinematics of the cervical spine: effects of multiple total laminectomy and facet wiring. J Orthop Res. 1988;6(4):611-9.
9. Handa Y, Kubota T, Ishii H, Sato K, Tsuchida A, Arai Y. Evaluation of prognostic factors and clinical outcome in elderly patients in whom expansive laminoplasty is performed for cervical myelopathy due to multisegmental spondylotic canal stenosis. A retrospective comparison with younger patients. J Neurosurg. 2002;96(2 Suppl):173-9.
10. Hardman J, Graf O, Kouloumberis PE, Gao WH, Chan M, Roitberg BZ. Clinical and functional outcomes of laminoplasty and laminectomy. Neurol Res. 2010; 32:416–420.
11. Hu W, Shen X, Sun T, Zhang X, Cui Z, Wan J. Laminar reclosure after single open-door laminoplasty using titanium miniplates versus suture anchors. Orthopedics. 2014;37(1):e71-8
12. Iwasaki M, Kawaguchi Y, Kimura T, Yonenobu K J. Long-term results of expansive laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine: more than 10 years follow up. Neurosurg. 2002;96(2 Suppl):180-9.
13. Kaminsky SB, Clark CR, Traynelis VC Iowa. Operative treatment of cervical spondylotic myelopathy and radiculopathy. A comparison of laminectomy and laminoplasty at five year average follow-up. Orthop J. 2004;24:95-105
14. Kamizono J, Matsunaga S, Hayashi K, Shinkura R, Koriyama C, Sakou T, Komiya S. Occupational Recovery After Open-Door Type Laminoplasty for Patients With Ossification of the Posterior Longitudinal Ligament. Spine (Phila Pa 1976). 2003;28(16):1889-92.
15. Kimura A, Seichi A, Inoue H, Hoshino Y. Long-term results of double-door laminoplasty using hydroxyapatite spacers in patients with compressive cervical myelopathy. Eur Spine J. 2011;20:1560–1566
16. Kaptain GJ, Simmons NE, Replogle RE, Pobereskin L. Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg. 2000;93(2 Suppl):199-204.
17. Kawaguchi Y, Kanamori M, Ishihara H, Ohmori K, Abe Y, Kimura T. Pathomechanism of myelopathy and surgical results of laminoplasty in elderly patients with cervical spondylosis. Spine (Phila Pa 1976). 2003;28(19):2209-14. (a)
18. Kawaguchi Y, Kanamori M, Ishihara H, Ohmori K, Nakamura H, Kimura T. Minimum 10-year follow up after en bloc cervical laminoplasty. Clin Orthop Relat Res. 2003;(411):129-39. (b)
19. Kohno K, Kumon Y, Oka Y, Matsui S, Ohue S, Sakaki S. Evaluation of prognostic factors following expansive laminoplasty for cervical spinal stenotic myelopathy. Surg Neurol. 1997;48(3):237-45.
20. Machino M, Yukawa Y, Hida T, Ito K, Nakashima H, Kanbara S, Morita D, Kato F. Modified double-door laminoplasty in managing multilevel cervical spondylotic myelopathy: surgical outcome in 520 patients and technique description. J Spinal Disord Tech. 2013;26(3):135-40
21. Machino M, Yukawa Y, Imagama S, Ito K, Katayama Y, Matsumoto T, Inoue T, Ouchida J, Tomita K, Ishiguro N, Kato F. Surgical Treatment Assessment of Cervical Laminoplasty Using Quantitative Performance Evaluation in Elderly Patients: A Prospective Comparative Study in 505 Patients With Cervical Spondylotic Myelopathy. Spine (Phila Pa 1976). 2016;41(9):757-63.
22. Mikawa Y, Shikata J, Yamamuro T. Spinal deformity and instability after multilevel cervical laminectomy. Spine (Phila Pa 1976). 1987;12(1):6-11.
23. Montano N, Trevisi G, Cioni B, Lucantoni C, Della Pepa GM, Meglio M, Papacci F. The role of laminoplasty in preventing spinal deformity in adult patients submitted to resection of an intradural spinal tumor. Case series and literature review. Clin Neurol Neurosurg. 2014;125:69-74.
24. Morimoto T, Matsuyama T, Hirabayashi H, Sakaki T, Yabuno T. Expansive laminoplasty for multilevel cervical OPLL. J Spinal Disord. 1997;10(4):296-8.
25. Nakano N, Nakano T, Nakano K. Comparison of the results of laminectomy and open-door laminoplasty for cervical spondylotic myeloradiculopathy and ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976). 1988;13(7):792-4.
26. Nurboja B, Kachramanoglou C, Choi D. Cervical laminectomy vs laminoplasty: is there a difference in outcome and postoperative pain? Neurosurgery 2012;70:965–970
27. Ogawa Y, Toyama Y, Chiba K, Matsumoto M, Nakamura M, Takaishi H, Hirabayashi H, Hirabayashi. Long-term results of expansive open-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine. J Neurosurg Spine. 2004;1(2):168-74
28. Oichi T, Oshima Y, Taniguchi Y, Matsubayashi Y, Chikuda H, Takeshita K, Tanaka S. Cervical Anterolisthesis: A Predictor of Poor Neurological Outcomes in Cervical Spondylotic Myelopathy Patients After Cervical Laminoplasty. Spine (Phila Pa 1976). 2016;41(8):E467-73
29. Okada M, Minamide A, Endo T, Yoshida M, Kawakami M, Ando M, Hashizume H, Nakagawa Y, Maio K. A prospective randomized study of clinical outcomes in patients with cervical compressive myelopathy treated with open-door or French-door laminoplasty. Spine (Phila Pa 1976). 2009;34(11):1119-26
30. Ratliff JK, Cooper PR. Cervical laminoplasty: a critical review. J Neurosurg. 2003;98(3 Suppl):230-8.
31. Sakaura H, Hosono N, Mukai Y, Iwasaki M, Yoshikawa H. Medium-term outcomes of C3–6 laminoplasty for cervical myelopathy: a prospective study with a minimum 5-year follow-up. Eur Spine J. 2011;20:928–933
32. Sakaura H, Miwa T, Kuroda Y, Ohwada T. Incidence and Risk Factors for Late Neurologic Deterioration after C3-C6 Laminoplasty for Cervical Spondylotic Myelopathy. Global Spine J. 2016;6(1):53-9.
33. Satomi K, Nishu Y, Kohno T, Hirabayashi K. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine (Phila Pa 1976). 1994;19(5):507-10.
34. Satomi K, Ogawa J, Ishii Y, Hirabayashi K. Short-term complications and long-term results of expansive open-door laminoplasty for cervical stenotic myelopathy. Spine J. 2001;1(1):26-30.
35. Seichi A, Takeshita K, Ohishi I, Kawaguchi H, Akune T, Anamizu Y, Kitagawa T, Nakamura K. Long-Term Results of Double-Door Laminoplasty for Cervical Stenotic Myelopathy. Spine (Phila Pa 1976). 2001;26(5):479-87.
36. Shigematsu H, Ueda Y, Takeshima T, Koizumi M. Degenerative spondylolisthesis does not influence surgical results of laminoplasty in elderly cervical spondylotic myelopathy patients. Eur Spine J. 2010;19:720–725
37. Shiraishi T. Skip laminectomy--a new treatment for cervical spondylotic myelopathy, preserving bilateral muscular attachments to the spinous processes: a preliminary report. Spine J. 2002;2(2):108-15.
38. Shiraishi T, Fukuda K, Yato Y, Nakamura M, Ikegami T. Results of skip laminectomy-minimum 2-year follow-up study compared with opendoor laminoplasty. Spine (Phila Pa 1976). 2003;28(24):2667-72.
39. Sim FH, Svien HJ, Bickel WH, Janes JM. Swan-neck deformity following extensive cervical laminectomy. A review of 21 cases. J Bone Joint Surg Am. 1974; 56:564–580
40. Sivaraman A, Bhadra AK, Altaf F, Singh A, Rai A, Casey AT, Crawford RJ. Skip laminectomy and laminoplasty for cervical spondylotic myelopathy: a prospective study of clinical and radiologic outcomes. J Spinal Disord Tech. 2010; 23:96–100
41. Wang MY, Shah S, Green BA. Outcomes Following Cervical Laminoplasty for 204 Patients with Cervical Spondylotic Myelopathy. Surg Neurol 2004;62:487–93
42. Wang ZF, Chen GD, Xue F, Sheng XW, Yang HL, Qian J Indian J. All levels versus alternate levels plate fixation in expansive open door cervical laminoplasty. Orthop. 2014;48(6):582-6
43. Yeh KT, Yu TC, Chen IH, Peng CH, Liu KL, Lee RP, Wu WT. Expansive open-door laminoplasty secured with titanium miniplates is a good surgical method for multiple-level cervical stenosis. J Orthop Surg Res. 2014;9:49.
44. Yukawa Y, Kato F, Ito K, Horie Y, Hida T, Ito Z, Matsuyama Y. Laminoplasty and skip laminectomy for cervical compressive myelopathy: range of motion, postoperative neck pain, and surgical outcomes in a randomized prospective study. Spine. 2007;32:1980–1985.
45. Zhang H, Zhu R, Yang H, Zhu X, Zhou F. Multifactor Analysis on the Outcomes of Cervical Spondylotic Myelopathy with Expansive Open-door Laminoplasty. J Int Med Res. 2012;40(4):1608-16.
46. Zhang SM, Zhou W, Li X, Zhang LT, Liu YZ, Zhang ZJ. Clinical application of titanium miniplate in cervical expansive open-door laminoplasty. Zhongguo Gu Shang. 2012;25(1):4-8.