We studied clinical utility of open door laminoplasty with foraminotomy in CSM with multilevel radiculopathy. We divided into two groups; the first group underwent laminoplasty with formainotomy, and the second group underwent laminoplasty and multiple ant. approaches. In the first group, the JOA score increased from a preoperative 13.3 to postoperative 16.0 (range, 10 to 18), and in the second group from 12.8 to 15.5 (range, 10 to 18). However, the pre-operative VAS score was 6.1, 6.5 and, 2 weeks after surgery, had decreased to 2.4, 1.4, the last score was the same, 1.8, finally. The open door lami-noplasty with foraminotomy was easily performed and clinical profiles were similar to those for the laminoplasty and multi-ple anterior approach.