Plate-Only Open Door Laminoplasty Maintains Stable Spinal Canal Expansion with High Rates of Hinge Union and No Plate Failures

Rhee, John M.; Register, Bradley C.; Hamasaki, Takahiko; Franklin, Betty

doi:10.1097/brs.0b013e3181fea49c

Cited by 84 publications

(95 citation statements)

References 7 publications

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“…Previous reports showed that the hinge fusion rate at 1 year after the operation was 93 % with mini-plates [9], 98 % with hydroxyapatite spacers, and 97 % with autogenous spacers [7], In the present study, the overall fusion rate was 98.2 % at a mean of 12.7 months after the operation, and was 100 % at follow-ups performed C1 year after the operation. These values were comparable or slightly superior to those for the other techniques.…”

Section: Discussionsupporting

confidence: 56%

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Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs

et al. 2016

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Section: Discussionsupporting

confidence: 56%

“…Later, various materials were used to keep the laminae open, such as autologous bone, mini-plates, and ceramic spacers [6]. Furthermore, several studies have investigated bony healing after laminoplasty [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs

et al. 2016

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“…15,21,35 However, delayed spinal cord compression by dislodged HA spacers has been reported. 21,26 Retrospective studies have shown bony union rates of 61% to 77% achieved by using HA spacers after doubledoor laminoplasty.…”

Section: Bone-spacer Bonding and Bony Unionmentioning

confidence: 99%

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

Umeda

Sasai

Kushida

et al. 2013

SPI

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Object Modified cervical laminoplasty techniques have been developed to reduce postoperative axial neck pain and preserve function in patients with cervical spondylotic myelopathy (CSM). However, the previous studies demonstrating satisfactory surgical outcomes had a retrospective design. Here, the authors aimed to prospectively evaluate the 2-year outcomes of a modified cervical laminoplasty technique for CSM that preserves the paravertebral muscles. Methods Outcomes were analyzed for 40 patients (22 men and 18 women; mean age, 66.6 years; age range 44–92 years) with CSM who underwent C4–6 laminoplasty with C-3 and C-7 partial laminectomies or C-3 total and C-7 partial laminectomies and received hydroxyapatite spacers. Neurological, pain severity, and spinal radiographic evaluations were performed preoperatively and at 3, 6, 12, 18, and 24 months postoperatively. Plain radiography and MRI of the cervical spine were performed to evaluate the range of motion (ROM), sagittal alignment, and cross-sectional areas of the deep extensor muscles. The extent of bone–spacer bonding and bony union at the gutter was assessed by CT. Results The mean preoperative Japanese Orthopaedic Association CSM score was 10.2, but it increased to 14.4 by 24 months after surgery. Eleven patients had axial neck pain preoperatively, but only 3 reported mild pain at 24 months, and in all 3 cases the pain was mild. The mean angle of lordosis was 11.7° preoperatively and 12.0° 2 years postoperatively. Although the ROM at the C2–7 levels was significantly reduced 3 months postoperatively, an increasing trend was observed up to 12 months, and 86% of the preoperative ROM was achieved by 2 years postoperatively. The mean paravertebral muscle cross-sectional areas were 833 ± 215 mm2 preoperatively and 763 ± 197 mm2 24 months postoperatively, but the difference was not statistically significant. The rates of bone–spacer bonding and bony union at the gutter were low during the early stages but increased to 90% and 93%, respectively, by 2 years after surgery. Conclusions The modified laminoplasty technique used in this study ensured very good neurological status and ROM after 2 years and was associated with low incidences of axial neck pain and serious complications. This simple and easy operative method could benefit future laminoplasty protocols.

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“…In one study of plateonly laminoplasty, at one year the hinge non-union rate was 7% and the screw pullout rate was 2.3%, but there was no plate dislodgement or laminoplasty closure. 18 The major risks of lateral mass screw fixation are damage to the vertebral artery, spinal nerves, or facet joints. Unicortical purchase eliminates the risk of damaging neurovascular structures.…”

Section: Discussionmentioning

confidence: 99%

Single-Door Cervical Laminoplasty Using Titanium Miniplates Alone

Tung

Cheung

Kwok

et al. 2015

J Orthop Surg (Hong Kong)

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Purpose. To review outcome of 29 patients who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone. Methods. Records of 20 men and 9 women aged 35 to 79 (mean, 64.3) years who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone were reviewed. A total of 125 laminae were opened; 97 of them were fixed with a titanium miniplate. In 19 patients, a 20-hole titanium miniplate bent to the contour of a lamina was used and fixed into 3 laminae at alternate levels. In the remaining 10 patients, the pre-contoured ARCH Laminoplasty System was used and fixed into all laminae. In most patients, screw fixation was unicortical, and no spacer or bone graft was used. Results. The mean follow-up duration was 4 (range, 2-9) years. At one-year follow-up, the mean Japanese Orthopaedic Association (JOA) score improved from 9.2 to 13.2 (p<0.001). The mean JOA recovery rate was 64%. No patient had neurological deterioration. The mean anteroposterior diameter increased from 14.3Single-door cervical laminoplasty using titanium miniplates alone mm to 19.7 mm; the mean increase was 6.1 mm in the plated laminae and 5.3 mm in the unplated laminae (p=0.11). Out of the 125 laminae, there were 2 hinge non-unions in the unplated laminae, and 2 screw pullouts (not associated with plate loosening). No patient had penetration into the vertebral foramen or neuroforamen. Spring-back closure occurred in 5 (18%) of the 28 unplated laminae, with a mean of <3 mm loss of the initial expansion. Two patients developed transient C5 palsy presenting as shoulder abduction weakness. One patient had a delayed dural tear due to a sharp spike at the edge of the opened C6 lamina. Conclusion. Single-door cervical laminoplasty using miniplates alone is a safe technique and achieves a high hinge union rate, good canal expansion, and neurological recovery.

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Plate-Only Open Door Laminoplasty Maintains Stable Spinal Canal Expansion with High Rates of Hinge Union and No Plate Failures

Cited by 84 publications

References 7 publications

Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs

Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

Single-Door Cervical Laminoplasty Using Titanium Miniplates Alone

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