Recovery After Cervical Laminoplasty for Cervical Compression Myelopathy

When someone develops cervical compression myelopathy, this means some vertebrae (bones) in the neck are pressing together, causing pain and other problems. The standard treatment for this problem is a surgery called cervical laminoplasty. The surgery has a fairly good success rate and long-term outcome. However, recovery can be slow. The authors of this article investigated the recovery process to determine the length of time and other issues that may arise.

Researchers studied 98 adult patients who had the surgery for cervical compression myelopathy (69 men). The patients were divided into two groups, according to age: under 70 years old and 70 years old or older. The patients were followed for between five and 12 years. The cause of the compression included cervical spondylosis (arthritis) in 60 patients, cervical disc herniation (slipped or bulging discs) in 20 patients, and ossification of a ligament (hardening into bone) in 18 patients.

The testing consisted of measuring items according to the Japanese Orthopedic Association score, 10 seconds grip and release test for hand coordination, and grasp strength. The tests were done just before surgery and repeated at three, six, nine, 12, 18, 24, 36, 48, and 60 months after surgery. The results showed that the Japanese Orthopedic scores improved at five years after surgery with half of the patients recovering well at this point. For 80 patients, the maximum score was reached within a year. The score plateaued though, stayed even, after about 8.8 months, while the grasp strength continued to improve until an average of 25.6 months after surgery. Patients in the older group took longer to recover than the younger group. As well, patients who had symptoms for less than one year recovered much more quickly than those who had symptoms for one year or longer.

The authors concluded that recovery from this type of surgery can take up to two years and is affected by both age and how long the problem has been symptomatic.