Can Prophylactic Bilateral C4/C5 Foraminotomy Prevent Postoperative C5 Palsy After Open-Door Laminoplasty?

• DOI: 10.1097/brs.0b013e3182326957
• Publication Date: 2011-10-04T18:02:54Z
• Authors: Keiichi Katsumi; Akiyoshi Yamazaki; Kei Watanabe; Masayuki Ohashi; Hirokazu Shoji
• Keywords: Foraminotomy; Laminoplasty; Laminotomy

In Brief Study Design. A prospective study. Objective. To evaluate the effectiveness of prophylactic C4/C5 microforaminotomy with open-door laminoplasty for cervical myelopathy in preventing postoperative C5 palsy. Summary Background Data. Postoperative palsy is a common complication laminoplasty. Although etiology and preventive measures remain unclear, we hypothesize that caused by nerve root impairment induced potential foraminal stenosis posterior shifting spinal cord after Methods. The study included 141 consecutive patients (103 men 38 women) who underwent bilateral foraminotomy between 2009 2010. These were designated as group (FG). One hundred forty-one (100 41 without during 2006 to 2008 served control group. This was nonforaminotomy (NFG). incidence palsy, operation time, blood loss, number decompressed disc levels recorded. Results. 1.4% (2 cases) FG, 6.4% (9 NFG. mean times 129 102 minutes, respectively. There significant differences time (both comparisons, P < 0.05). no loss or > Conclusion. Prophylactic significantly decreased results suggest main impairment. However, 2 experienced despite undergoing foraminotomy, which indicated other factors including acute decompression against canal may also be considered minor etiologies We conclude an effective measure investigated compared pre-existing stenosis.