Impact of lamina-open side on unilateral open door laminoplasty in patients with degenerative cervical myelopathy

Surgeons should select one side for cervical unilateral open door laminoplasty (UODL). However, few reports suggest proper guidelines for deciding which side to open. The aim of this study is to evaluate the impact of opening side in UODL on dominant cord compressive or symptomatic side. 193 degenerative cervical myeloradiculopathy patients with followed-up more than 2 years were enrolled. In all cases, UODL was performed uniformly on the right side. Patients were sub-grouped based on preoperative dominant 3 characteristics: cord compression, myelopathy symptom and radiculopathy symptom (right, symmetric, left). Pre- and postoperative radiographic and clinical parameters and incidence of postoperative C5 palsy were analyzed and compared among the groups. According to dominant compressive side, there were no significant differences in postoperative radiographic and clinical parameters among three groups. According to dominant myelopathy or radiculopathy symptom side, there were no significant differences of all radiographic and clinical parameters postoperatively, except slightly lower neck VAS in groups of preoperative right dominant myelopathy or radiculopathy symptom side at postoperative 1 month. C5 palsies occurred in twelve patients (6.2%), but the incidences were not different among the groups. Therefore, when performing UODL, the choice of lamina opening side can be left to surgeon’s preference.