A Clinical Experience in Treating Myelopathy Caused by Floating Lamina Resulting from Re-close of the Lamina and Pseudarthrosis at the Lateral Gutter after Cervical Laminoplasty

Introduction: Although cervical laminoplasty is a commonly performed procedure, several potential pitfalls must be recognized. Case Report: The patient was a 68-year-old man who presented with myelopathy caused by a floating lamina resulting from pseudoarthrosis at the lateral gutter and reclosure of the lamina following cervical laminoplasty. Intraoperatively, the C2 and C3 laminae were found to be mobile. To avoid spinal cord injury, the laminae were stabilized using forceps while carefully drilling them with a high-speed burr under spinal cord monitoring. Scar tissue was removed, and the dural sac was decompressed. The patient's symptoms improved early after surgery. Conclusion: In the present case, medial deviation of the lateral gutter and damage to the inner cortex of the lamina during the initial surgery likely led to pseudoarthrosis at the lateral gutter. Subsequent osteophyte formation associated with the pseudoarthrosis, along with reclosure of the lamina, resulted in recurrence of myelopathic symptoms. Careful attention to the positioning of the lateral gutter is therefore essential when performing cervical laminoplasty.