Expansive Laminoplasty

  • Sumio Goto
  • Masashi Yamazaki
  • Hideshige Moriya


Laminoplasty has been performed throughout Japan since the early 1980s as a posterior approach for the treatment of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament (OPLL), and it has generally been considered to provide a good postoperative outcome. However, a thorough evaluation of the long-term follow-up data over more than 10 years has revealed a considerable number of cases in which the patient has deteriorated, indicating the limitations of surgical improvement even with laminoplasty [1]. To achieve longer-term stability of the spine, we first need to understand fully the mechanism of decompression associated with posterior approaches and associated problems [2], and second we must determine precisely which cases are suitable for posterior or anterior approaches based on the condition of the lesions. In addition, when posterior approaches are selected, we should further select either standard laminoplasty involving the range from the C3 to C7 laminae, or expansive laminoplasty involving the extended range from the C2 to T1 laminae. We should also note that approaches to surgical treatment differ between cervical spondylotic myelopathy and OPLL. In this chapter, we outline (i) the types of laminoplasty that we currently adopt, especially the surgical technique of expansive laminoplasty, (ii) the decompression mechanism of laminoplasty, and (iii) the selection criteria for anterior and posterior approaches.


Posterior Approach Cervical Spondylotic Myelopathy Articular Process Good Postoperative Outcome Segmental Shape 
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  1. 1.
    Goto S, Mochizuki M, Kita T, et al. (1993) Anterior surgery in four consecutive technical phases for spondylotic myelopathy. Spine 18:1968–1973PubMedCrossRefGoogle Scholar
  2. 2.
    Sodeyama T, Goto S, Mochizuki M, et al. (1999) Effect of decompression enlargement laminoplasty for posterior shifting of the spinal cord. Spine 24:1527–1531PubMedCrossRefGoogle Scholar
  3. 3.
    Goto S, Mochizuki M, Watanabe T, et al. (1993) Long-term follow-up study of anterior surgery for cervical spondylotic myelopathy with special reference to the magnetic resonance imaging findings in 52 cases. Clin Orthop 291:142–153PubMedGoogle Scholar
  4. 4.
    Goto S, Kita T (1995) Long-term follow-up evaluation of surgery for ossification of the posterior longitudinal ligament. Spine 20:2247–2256PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 2003

Authors and Affiliations

  • Sumio Goto
    • 1
  • Masashi Yamazaki
    • 2
  • Hideshige Moriya
    • 2
  1. 1.Department of Orthopaedic SurgeryNational Center of Neurology and Psychiatry, Kohnodai HospitalIchikawa, ChibaJapan
  2. 2.Department of Orthopaedic SurgeryChiba University School of MedicineChibaJapan

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