Laminectomy and Fusion and Laminoplasty: Indications and Techniques


Posterior cervical decompression has been available as a treatment option for cervical spondylotic myelopathy since the 1940s. Patients may present with axial neck pain, radiculopathy, myelopathy, or a combination of these symptoms. The natural history of cervical spondylotic myelopathy is generally defined by slow, progressive deterioration. Posterior surgical options include multilevel laminectomy and fusion or laminoplasty. Laminectomy without fusion has also been extensively used in the past, but is less commonly used now because of a high rate of postoperative complications. The choice of posterior procedure is based on multiple factors, including the severity of disease and levels of compression, the presence of degenerative changes, preoperative sagittal alignment, instability, and other patient factors.

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