Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of unilateral open-door laminoplasty com- bined with total spinous process resection by ultrasound osteotome for cervical spondylotic myelopathy. [Methods] From January 2020 to December 2021, 30 patients received aforesaid surgical treatment for cervical spondylotic myelopathy. As diluted epinephrine saline solu- tion was injected around the incision, a posterior midline incision was made to expose the spinous process and lamina by dissecting bilateral paraspinous muscles from C3 to C6. An ultrasonic osteotome was used to make grooves with a thin intact inner plate along the junction of the lamina and lateral mass on the axial side, whereas full layer resection on the decompression side (the symptomatic side) . Lifting the lamina one by one to widen and decompress the spinal canal, and then the corresponding open-door segments were fixed with Z-shaped titanium plates in appropriate size to maintain the lamina opening. Subsequently, C3~C6 spinous process were totally removed from the base by ultra- sonic osteotome to facilitate reattachment of paraspinous muscles without dead space. [Results] All the patients had operation performed successfully without serious complications. The VAS score was improved from (3.6±0.9) before operation to (1.2±0.6) at the last follow-up, while JOA score was improved from (8.5±1.2) preoperatively to (15.0±0.9) at the latest follow-up, which all were statistically significant (P＜ 0.05) . During the follow-up period, none of implant loosening and fracture, nor “re-closing” phenomenon were noted in anyone of the 30 patients. [Conclusion] Total resection of spinous processes of C3~C6 might reduce the stress shielding on the neck muscles, and this bilater- al basically symmetrical construct is more conducive to the reattachment of muscles.