Effectiveness of multiple-level decompression in laminoplasty and simultaneous C1 laminectomy for patients with cervical myelopathy

Zhang, Junwei; Hirabayashi, Shigeru; Saiki, Kunio; Sakai, Hiroya

doi:10.1007/s00586-005-0025-4

Cited by 14 publications

(17 citation statements)

References 21 publications

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“…It remains unclear to what minimal extent the spinal canal must be widened in order to obtain good surgical results [13]. In this series, the authors did not discuss the relationship between the expansion ratio and the clinical outcome because not all of the patients had pathognomonic lesions at the C5 and C6 levels.…”

Section: Appropriate Surgical Indicationsmentioning

confidence: 95%

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

et al. 2010

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The purpose of this study was to compare the degree of enlargement of the spinal canal between two methods of cervical laminoplasty (open-door laminoplasty and double-door laminoplasty) and to determine their appropriate surgical indications based on the results. Tension-band laminoplasty (TBL, one method of open-door type) was performed in 33 patients and double-door laminoplasty (DDL) in 20 patients. The operation level ranged from C2 to C7 in all patients. The width of the spinal canal and the inclination angle of the lamina at the C5 and C6 levels were measured using a computer software program (Image J) and pre-and postoperative CT films. Concerning the degree of enlargement of the spinal canal, the mean expansion ratio at the C5 level was 148.9% in TBL and 148.2% in DDL, and there was no significant difference between them. However, at the C6 level, it was 159.0% in TBL and 140.3% in DDL, which was significantly larger in TBL than DDL (p \ 0.05). The increase of inclination angle of the lamina was 11.0°in TBL and 19.0°in DDL at the C5 level, and 9.2°in TBL and 19.3°in DDL at the C6 level. At both the C5 and C6 levels, it was significantly larger in DDL than TBL (p \ 0.0001). In conclusion, the appropriate surgical indications of TBL were considered to be (1) cervical spondylotic myelopathy (CSM) combined with hemilateral radiculopathy, (2) severe prominence of ossification of the posterior longitudinal ligament (OPLL), and (3) patients with tiny spinous processes who cannot undergo DDL. Those of DDL were considered to be (1) usual CSM, (2) small and slight prominence of OPLL, (3) CSM combined with bilateral radiculopathy, and (4) cervical canal stenosis combined with instability necessitating posterior spinal instrumentation surgery.

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Section: Appropriate Surgical Indicationsmentioning

confidence: 95%

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

et al. 2010

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“…In this procedure, the expansion of the spinal canal and preservation of the posterior structures for stability of the cervical spine are important 18) . French-door laminoplasty allows for easy placement of spacers and performance of bilateral decompression 1 8 9 10 32) . And, French-door laminoplasty has shown superior clinical and radiological outcomes compared to open-door laminoplasty, in addition to preserving cervical muscle strength after laminoplasty 17 20 22) .…”

Section: Discussionmentioning

confidence: 99%

Preliminary Experiences of the Combined Midline-Splitting French Door Laminoplasty with Polyether Ether Ketone (PEEK) Plate for Cervical Spondylosis and OPLL

Oh¹,

Hur

et al. 2015

Korean J Spine

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ObjectiveThe purpose of this study was to evaluate the safety and efficacy of cervical midline-splitting French-door laminoplasty with a polyether ether ketone (PEEK) plate. The authors retrospectively analyzed the results of patients with cervical laminoplasty miniplate (MAXPACER®) without bone grafts in multilevel cervical stenosis.MethodsFifteen patients (13 males and 2 females, mean age 50.0 years (range 35-72)) with multilevel cervical stenosis (ossification of the posterior longitudinal ligament and cervical spondylotic myelopathy) underwent a combined surgery of midline-splitting French-door laminoplasty with or without mini plate. All 15 patients were followed for at least 12 months (mean follow-up 13.3 months) after surgery, and a retrospective review of the clinical, radiological and surgical data was conducted.ResultsThe radiographic results showed a significant increase over the postoperative period in anterior-posterior diameter (9.4±2.2 cm to 16.2±1.1 cm), open angles in cervical lamina (46.5±16.0° to 77.2±13.1°), and sectional volume of cervical central canal (100.5±0.7 cm2 to 146.5±4.9 cm2) (p<0.001). The sagittal alignment of the cervical spine was well preserved (31.7±10.0° to 31.2±7.6°, p=0.877) during the follow-up period. The clinical results were successful, and there were no significant intraoperative complications except for screw displacement in two cases. The mini plate constructs did not fail during the 12 month follow-up period, and the decompression was maintained.ConclusionDespite the small cohort and short follow-up duration, the present study demonstrated that combined cervical expansive laminoplasty using the mini plate is an effective treatment for multilevel cervical stenosis.

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“…In this procedure, expansion of the spinal canal and preservation of the posterior structures for stability of the cervical spine are important 16) . Double-door laminoplasty allows easy placement of spacers and performance of bilateral decompression 1 , 7 , 8 , 9 , 15 , 25) .…”

Section: Discussionmentioning

confidence: 99%

Cervical Expansive Laminoplasty with 90° Box-Shape Double Door Method

Zhang

Park

2012

Korean J Spine

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ObjectiveThe aim of this study is to introduce the surgical method with miniplate and compared the expansion rate of the spinal canal area with other kinds of lamina spacers.MethodsBetween June. 2008 and May 2011, we performed expansive cervical laminoplasty on 61 patients. We analyzed the results of these operations, examining type of lamina spacer used, spinal canal areas between pre- and postoperative CT scans, and operative methods.Results39 patients were analyzed retrospectively. Miniplates were used in 21 patients with 103 levels. Hydroxyapatite (HA) was used in 6 patients with 29 levels, and Centerpiece® was used in 12 patients with 54 levels. The expansion area was calculated using Photoshop CS3®. The expansion rate of the miniplates was 76.5%, that of HA was 49.8%, and that obtained with Centerpiece was 50.6%. The excellent 90° box-shaped widening of the laminae achieved through the surgery can be checked easily by AP X-ray. All miniplates are positioned horizontally and parallel, and the lamina is seen as a pedicle of thoracic or lumbar spine due to its 90° erect position. Neurologic improvement and clinical outcomes will be discussed. No complications were reported with miniplates.ConclusionBox-shaped laminoplasty with miniplates is the widest spinal canal expansion method among the three types of implants examined.

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Effectiveness of multiple-level decompression in laminoplasty and simultaneous C1 laminectomy for patients with cervical myelopathy

Cited by 14 publications

References 21 publications

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

Preliminary Experiences of the Combined Midline-Splitting French Door Laminoplasty with Polyether Ether Ketone (PEEK) Plate for Cervical Spondylosis and OPLL

Cervical Expansive Laminoplasty with 90° Box-Shape Double Door Method

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