Reoperation Rates after Laminoplasty for Cervical Disorders: A 26-Year Period Survival Function Method Analysis

• Main Authors: Ko Hashimoto, Toshimi Aizawa, Hiroshi Ozawa, Yasuhisa Tanaka, Takashi Kusakabe, Naoki Morozumi, Yutaka Koizumi, Tetsuro Sato, Hironori Hyodo, Tomowaki Nakagawa, Eiji Takahashi, Takeshi Hoshikawa, Hideki Imaizumi, Shinji Ogawa, Fumio Kasama, Haruo Kanno, Eiji Itoi, Shoichi Kokubun
• Format: Article
• Language: English
• Published: The Japanese Society for Spine Surgery and Related Research 2019-10-01
• Series: Spine Surgery and Related Research
• Subjects: cervical myelopathy; midline-splitting laminoplasty; reoperation rate; survival function method analysis
• Online Access: https://www.jstage.jst.go.jp/article/ssrr/3/4/3_2019-0028/_pdf/-char/en

Introduction: Laminoplasty is a common surgery for cervical myelopathy. Previous studies have analyzed the reoperation rates in posterior decompression surgeries of the cervical spine. However, few studies have solely focused on midline-splitting laminoplasty (MSL) using a large number of patients. This aims to analyze the reoperation rates after MSL using the survival function method. Methods: Between 1988 and 2013, 4,208 MSLs were performed as a primary operation for cervical myelopathy and enrolled in our spinal surgery registration system. The Kaplan-Meier survival function method was used to analyze the rates of reoperation. Results: Of 4,208 patients with primary MSL, 40 underwent reoperation for neurological complications. The overall reoperation rate was 0.26%, 0.64%, 0.83%, 0.93%, and 0.95% at 1, 5, 10, 20, and >20 years, respectively. The causes of reoperation were postoperative cervical radiculopathy in 10 patients, stenosis at an adjacent level in 8, stenosis due to failed “open-door” lamina in 6, instability of the cervical spine in 4, cervical disc herniation in 3, elongation of ossification of the posterior longitudinal ligament in 3, spinal cord injury in 1, fracture of the cervical spine in 1, postoperative scar formation in 1, ossification of anterior longitudinal ligament in 1, and unknown in 2. The number of patients with surgical site infection (SSI) who needed surgical debridement was 34 (0.81%). Conclusions: Excluding reoperations for SSI, the reoperation rate of MSL was approximately 1.0% at the maximum of 26 years after surgery. MSL was determined to be a reliable surgical procedure regarding postoperative complications requiring additional surgeries.