LAMINOPLASTY WITH FORAMINOTOMY FOR COEXISTING CERVICAL MYELOPATHY ANDUNILATERAL RADICULOPATHY - A PRELIMINARY-REPORT

Study Design, An assessment was made of the efficacy of a combined lam inoplasty and foraminotomy operation for patients with coexisting myel opathy and unilateral radiculopathy. The procedure was done in 17 pati ents. Objectives. The patients were followed with lateral flexion and extension radiographs, computed tomography scans, and an assessment sy stem specially designed to qualitatively evaluate the patients' neurol ogic status. Follow-up period averaged 4 years (range, 2.1-9.3 years). Summary of Background Date, Excellent-to-good results were obtained f or 76% (13 of 17) of the patients without any significant functional c ompromise based on the radiographs. Sixteen nerve roots were decompres sed with a less than 25% foraminotomy, whereas eight were decompressed by a 25%-50% foraminotomy without serious neurologic damage, except f or one patient. The neurologic results appeared unrelated to the exten t of foraminotomy. Methods. A refined procedure for combined laminopla sty and foraminotomy was reviewed retrospectively in terms of neurolog ic outcome and radiographic data. Results. The present series is small , and results are not comparable directly with other methods. The proc edure appears effective for myelopathy and radiculopathy. This procedu re is applicable to patients with myelopathy and coexisting nerve root impingement anterolaterally or in the neural foramen. Conclusion. The combined laminoplasty and foraminotomy operation may provide greater neurologic improvement in patients with coexisting myelopathy and unil ateral radiculopathy, while maintaining cervical spine stability after surgery.