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Single-door cervical laminoplasty using titanium miniplates alone.

AbstractPURPOSE:
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 14.3 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.
AuthorsKam Lung Tung, Philip Cheung, Tik Koon Kwok, Kam Kwong Wong, Kan Hing Mak, Wing Cheung Wong
JournalJournal of orthopaedic surgery (Hong Kong) (J Orthop Surg (Hong Kong)) Vol. 23 Issue 2 Pg. 174-9 (Aug 2015) ISSN: 2309-4990 [Electronic] England
PMID26321544 (Publication Type: Journal Article)
Chemical References
  • Titanium
Topics
  • Adult
  • Aged
  • Bone Plates
  • Bone Screws
  • Bone Transplantation (methods)
  • Cervical Vertebrae (surgery)
  • Equipment Design
  • Female
  • Humans
  • Laminoplasty (methods)
  • Male
  • Middle Aged
  • Miniaturization
  • Retrospective Studies
  • Spinal Cord Diseases (surgery)
  • Titanium

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