Clinical Outcome and Our Experience of 33 Consecutive Cases Treated With Cervical Microendoscopic Laminoplasty in a Single Clinic

TL;DR

This study reports on the outcomes of 33 patients who underwent cervical microendoscopic laminoplasty at a private clinic, showing mostly positive results with minimal complications.

Contribution

The paper provides a novel clinical report on the effectiveness and safety of CMEL in a private clinic setting with a short follow-up period.

Findings

CMEL was performed with a mean operative time of 105 minutes and minimal intraoperative bleeding.

Most patients had excellent or good outcomes according to the McNab score.

Postoperative extradural hematoma occurred in only one case.

Abstract

Introduction: Cervical microendoscopic laminoplasty (CMEL) is a less invasive operation for cervical myelopathy. This method is gradually spreading; however, the literature seems to have few reports concerning clinical outcomes. This study aims to report the effectiveness of CMEL performed in a private clinic.

Methods: Patients who underwent CMEL from April 2023 to July 2024 in our private clinic were retrospectively researched. The patient's background and the following operative data were collected, such as the number of vertebral levels treated with CMEL, additional foraminotomy, operative time, and intraoperative bleeding. Postoperative data were also collected, including admission days, complications, surgical outcomes, radiological changes, and follow-up periods. In this study, those patients with severe cardiovascular, pulmonary, and renal problems and/or significant motor weakness requiring postoperative rehabilitation were excluded.

Results: Consecutive 33 patients (30 spondylotic myelopathy and three ossification of the posterior longitudinal ligament) with a median age of 60 years were enrolled. CMEL was performed for a single level in 13 cases, two in 15, and three in five, respectively. Foraminotomy was concurrently performed in eight cases. The mean operative time and intraoperative bleeding were 105 minutes and 21 g, respectively. All the patients were discharged from the hospital the following day after surgery on their own without severe neck pain. Postoperative extradural hematoma occurred only in a single case, which was managed with an additional operation. The median postoperative follow-up period (minimum-maximum) was 9.5 (two to 18) months. The outcome evaluated with the McNab score was excellent (six cases), good (22 cases), fair (four cases), and poor (one case). The median C2-7 angle improved from 6.2° preoperatively to 8.1° postoperatively with no significant difference.

Conclusion: CMEL can be performed in a private clinic for patients without perioperative high risks.

Figures