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.

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. It has been reported that medial deviation of the lateral gutter can result in insufficient spinal cord decompression and increased damage to the inner cortex of the lamina, which can lead to pseudoarthrosis and subsequent reclosure of the lamina. In the present case, there was no evidence of kyphotic deformity or spinal instability. However, the initial surgery involved a narrow lateral gutter, which likely led to gradual reclosure of the lamina. Osteophyte formation due to pseudoarthrosis at the lateral gutter also contributed to the recurrence of myelopathy.