Clinical value of MRI laminar line-simulated decompression for predicting the efficacy of cervical laminoplasty

Abstract Aim The goal of this study was to investigate the clinical value of magnetic resonance imaging (MRI) laminar line (LL)-simulated decompression for predicting the efficacy of cervical laminoplasty (CLP). Methods Data of 60 patients who underwent CLP for cervical spondylotic myelopathy (CSM) from December 2020 to February 2023 were retrospectively analyzed. LL was defined as the line between the anterior-inferior margin of the superior lamina and the anterior-superior margin of the inferior lamina at the decompression segment, and the anterior dural border to the midsagittal diameter of LL (simulated decompression) was measured. The diameter of the dural sac in compression segment of preoperative MRI and spinal canal of postoperative MRI were measured. The correlations among the actual decompression diameter, the improvement rate of the modified Japanese Orthopedic Association (mJOA) score, the visual analog scale (VAS) score, the neck disability index (NDI) score, and the simulated decompression diameter were assessed. Results All patients were followed up for 12–38 months. Postoperative MRI results showed that the spinal cord was significantly shifted backward and the spinal cord compression was relieved. The midsagittal diameter of actual decompression and LL-simulated decompression were significantly increased compared with preoperative measurements (P < 0.001). The accuracy of LL simulation decompression was 91.7% (55/60) compared with the actual decompression effect. The mJOA, VAS and NDI scores were significantly higher at the final follow-up than before surgery (P < 0.001). Conclusions MRI LL-simulated decompression can predict the effect of spinal cord decompression and aid in the preoperative planning of CLP.