Outcomes of combined open-door laminoplasty with bilateral lateral mass screw fixation for traumatic unstable multilevel cervical stenosis: A retrospective case study

Abstract Background The purpose of this study was to report the outcomes of combined open-door laminoplasty with bilateral lateral mass screw fixation for traumatic unstable multilevel cervical stenosis. Methods Data from 11 patients who underwent combined open-door laminoplasty with bilateral lateral mass screw fixation for multilevel cervical stenosis with traumatic cervical instability and spinal cord injury between July 2016 and January 2020 were retrospectively reviewed. Patients treated via the anterior approach and those who did not undergo open-door laminoplasty were excluded. Neurological functional recovery was evaluated using the pre- and postoperative Japanese Orthopaedic Association (JOA) scores and Nurick scores. Results All patients underwent operative treatment without neurovascular complications. The average duration of follow-up was 26 months (range, 24 to 30 months). The mean JOA score improved from 5.0 ± 2.68 preoperatively to 12.54 ± 4.39 at final follow-up, and the mean JOA recovery rate was 61.5%. The mean Nurick disability score decreased from 3.27 ± 1.42 preoperatively to 1.45 ± 1.21 at final follow-up. Significant neurogenic recovery was indicated by both the JOA score (t=-4.86, p = 0.000) and the Nurick disability score (t = 3.22, p = 0.009). All patients achieved bone union of cervical fractures and fusion at an average of 3.5 weeks postoperatively (range, 12–16 weeks). No patient had segmental instability, laminar collapse, or internal fixation failure on postoperative radiographs. Conclusion Our findings suggest that combined open-door laminoplasty with lateral mass screw fixation achieves satisfactory cervical function in select patients with traumatic unstable multilevel cervical stenosis and spinal cord injury.