Radiculopathy after laminectomy for cervical compression myelopathy

Postoperative radiculopathy is a complication of posterior cervical decompr ession associated with tethering of the nerve root. We reviewed retrospecti vely 287 consecutive patients with cervical compression myelopathy who had been treated by multilevel cervical laminectomy and identified 37 (12.9%) w ith postoperative radiculopathy. There were 27 men and ten women with a mea n age of 56 years at the time of operation. The diagnosis was either cervic al spondylosis (25 patients) or ossification of the posterior longitudinal ligament (12 patients). Radiculopathy was observed from four hours to six days after surgery. The m ost frequent pattern of paralysis was involvement of the C5 and C6 roots of the motor-dominant type. The mean time for recovery was 5.4 months (two we eks to three years). The results at follow-up showed that the rate of motor recovery was negatively related to the duration of complete recovery of po stoperative radiculopathy (gamma = -0.832, p < 0.01) and that patients with spondylotic myelopathy had a significantly better rate of clinical recover y than those with ossification of the posterior longitudinal ligament (t = 2.960, p < 0.01). Postoperative radiculopathy may be prevented by carrying out an anterior de compression in conjunction with spinal fusion, which will achieve stabilisa tion and directly remove compression of the cord at multiple levels.