{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:19:14Z","timestamp":1761823154404},"reference-count":53,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Multilevel anterior cervical decompressive surgery and fusion effectively treats cervical myeloradiculopathy that is caused by severe cervical spinal stenosis, but degenerative changes at adjacent vertebral levels frequently result in long-term morbidity.<\/jats:p>\n<jats:p content-type=\"fine-print\">The authors performed a modified open-door laminoplasty procedure in which allograft bone and titanium miniplates were used to treat cervical myeloradiculopathy in younger patients with congenital canal stenosis while maintaining functional cervical motion segments. Pre- and postoperative magnetic resonance imaging and\/or computerized tomography myelography were performed to assess changes in cervical spinal canal dimensions. Pre- and postoperative flexion\u2014extension radiographs were compared to determine the residual motion of the targeted operative segments.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Twenty younger patients (average age 37.7 years) underwent modified open-door laminoplasty for treatment of myelopathy or myeloradiculopathy related to significant cervical spinal stenosis with or without associated central or lateral disc herniation or foraminal stenosis. These surgeries were performed during a 2-year period and follow-up review remains ongoing (average follow-up period 21.6 months). Reconstructive procedures were performed on an average of 4.1 levels (range three\u2014six). Operative time averaged 186 minutes (range 93\u2013229 minutes). Average blood loss was 305 ml (range 100\u2013650 ml). No cases were complicated by neurological deterioration, infection, wound breakdown, graft displacement, or hardware failure. The patients' Nurick Scale grade improved from a preoperative average of 1.8 to a postoperative average of 0.5.<\/jats:p>\n<jats:p content-type=\"fine-print\">Pre- and postoperative sagittal spinal diameter averaged 11.2 mm (8\u201314 mm) and 16.6 mm (13\u201319 mm), respectively. The sagittal compression ratio (sagittal\/lateral \u00d7 100%) increased from 48% pre- to 72% postoperatively. The spinal canal area increased an average of 55% (range 19\u2013127%). In patients in whom pre- and postoperative flexion\u2014extension radiographs were obtained, 72.7% residual neck motion was maintained. No patient developed increased neck or shoulder pain. Neurological symptoms improved in all patients, with total relief of myelopathy in 50% and partial improvement in 50%.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Modified open-door laminoplasty with allograft bone and titanium miniplates effectively treats neurological deficits in younger patients with congenital and spinal stenosis. Although long-term results are unknown, short-term results are good and there is a low incidence of complications.<\/jats:p>","DOI":"10.3171\/spi.1999.90.2.0170","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:46:08Z","timestamp":1241711168000},"page":"170-177","source":"Crossref","is-referenced-by-count":22,"title":["Modified open-door laminoplasty for treatment of neurological deficits in younger patients with congenital spinal stenosis: analysis of clinical and radiographic data"],"prefix":"10.3171","volume":"90","author":[{"given":"Christopher I.","family":"Shaffrey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory C.","family":"Wiggins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia B.","family":"Piccirilli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob 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