A Novel Technique for Laminoplasty Augmentation of Spinal Canal Area Using Titanium Miniplate Stabilization

Abstract

Normal canal dimensions can be reestablished with open-door laminoplasty. Achieving and maintaining an increased sagittal canal diameter is probably the most important change in anatomic parameters to facilitate neurologic recovery. The use of titanium miniplates to stabilize the posterior elements after laminoplasty is a simple, durable, and effective technique to maintain the increased sagittal diameter of the spinal canal.

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

“…For same-segment ODCL with the same LOS, the closer was the position of the lateral hinges to the inside of the lamina, the lower were the a and h values, the less was the distance between points E and F, and the smaller was the increase in SCD. As most authors believe that the lateral hinges should be positioned at the medial border of the lamina-lateral mass junction [15,[22][23][24], we followed this positioning in the current study.…”

A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results

“…This technique in creased the median sagittal diameter from 11.2 mm to 17.3 mm. Compared with other series [21][22][23][24] , our technique caused the greatest expansion in the medium sagittal diameter, as determined by radiographic evaluation (Figure 3). Other published series have reported similar results: Wang et al 3 reported an increase from 9.8 mm to 16.6 mm; O`Brien et al 23 reported an increase from 8.2 mm to 16.6 mm; and Satomi et al 24 reported an increase from 12.0 mm to 15.7 mm.…”

“…Compared with other series [21][22][23][24] , our technique caused the greatest expansion in the medium sagittal diameter, as determined by radiographic evaluation (Figure 3). Other published series have reported similar results: Wang et al 3 reported an increase from 9.8 mm to 16.6 mm; O`Brien et al 23 reported an increase from 8.2 mm to 16.6 mm; and Satomi et al 24 reported an increase from 12.0 mm to 15.7 mm. Kyphotic sagittal alignments reportedly developed in 0-10% of patients after laminoplasty, depending on the se ries [25][26][27][28][29][30] .…”

“…Another complication relating to the laminoplasty tech nique is the observance of C5 radiculopathy, which proba bly results from traction on the nerve, as the cord migrates dorsally after decompression. In published studies, this par ticular complication rate varies from 5% to 14% [22][23][24][25] . Sasai et al 25 discussed the role of prophylactic foraminotomies in de creasing the incidence of motor palsy after laminoplasties.…”

“…A review of the literature reveals no difference in the func tional outcomes of the laminoplasty variants [21][22][23][24] . Conversely, a great number of these variants are technically difficult to per form, while others are cumbersome in their use of bone grafting and require a prohibitive number of suture points.…”