Figure 176

Open-door laminoplasty. (A) Preoperative sagittal T2WI showing cord compression at four discal levels. (B, C) Postoperative CT axial cuts showing an open-door laminoplasty.

Oblique views may sometimes be helpful in evaluating a posterolateral fusion mass. Dynamic lateral flexion-extension X-rays can further help in the assessment of solid bony union. Plain films may also detect the presence of adjacent level disc degeneration with or without subluxation, such as spondylolisthesis, retrolisthesis, or, less often, lateral subluxation (Figure 17-7). They can also corroborate whether disc space infection has evolved, mostly after intradiscal surgery (i.e., after discectomy or intervertebral fusion, usually with cages) (Figure 17-8). Although plain films have a limited value in assessing recurrent hernia-tion or residual stenosis, they are invaluable for the appropriate postoperative assessment, and one should almost always obtain at least one postoperative X-ray, preferably in the standing position.

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