Postmortem findings in a woman with history of laminoplasty for severe cervical spondylotic myelopathy

This case report details the autopsy findings of a 65-year-old woman who had undergone laminoplasty for cervical spondylotic myelopathy (CSM) nine years prior to her death. The study correlates these pathological findings with her clinical history, particularly her improvement in symptoms following the surgery. The autopsy revealed atrophy in the ventral gray matter of the spinal cord at the C4–C5 level, giving it a triangular shape. A cystic cavity was observed in the gray matter, with scarce glial scar formation and no regeneration of gray matter. The white matter, particularly the posterior and lateral funiculi, showed shrinkage. Despite the pathological changes observed in the white matter, the patient had reported improvements in sensory disturbance, spasticity, and vesicorectal disturbance after the laminoplasty. This discrepancy suggests that irreversible histological changes may occur even when clinical symptoms improve, highlighting the importance of early surgical intervention in CSM.

• 1
  Atrophy was observed in the ventral gray matter at the C4-C5 level, causing a triangular shape in cross-sections of the spinal cord.
• 2
  A cystic cavity had formed in the gray matter, but there was little glial scar formation and no regeneration of gray matter.
• 3
  The posterior and lateral funiculi of the white matter were shrunken and atrophied, affecting three to four segments of the spinal cord.