Anterior decompression and fusion with an iliac bone and plate for kyphosis developing after cervical laminectomy: A case report

A 67-year-old man had previously undergone cervical laminectomy from C3 to C6 due to gait disturbance caused by cervical spondylosis and narrow canal. Two years after laminectomy, gait disturbance recurred and progressively worsened. Ten years after laminectomy, the patient was referred to our institution due to abrupt deterioration of cervical myelopathy. On admission, tetraparesis, numbness, and paresthesia of the arms and legs, and hyperreflexia were noted (neurosurgical cervical spine score: NCSS 5 points). Cervical radiographs and magnetic resonance images revealed a kyphotic deformity of the cervical spine and compression of the spinal cord at the C5 and C6 vertebral bodies. We performed C5 and C6 corpectomies and interbody fusion with an iliac bone graft and combined anterior fixation with the Orion plating system. Postoperatively, the kyphotic angle decreased from 30°to 7°, and the patient became ambulatory with aid (NCSS 8 points; improvement rate 33%). Surgical treatment for postlaminectomy kyphosis consists of decompression of neural elements, correction of the kyphotic deformity, and reconstruction of the cervical spine. Anterior decompression and fusion with an iliac bone graft and concomitant anterior plating is useful for the surgical management of postlaminectomy kyphosis.