Abstract | PURPOSE: 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.
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Authors | Kam Lung Tung, Philip Cheung, Tik Koon Kwok, Kam Kwong Wong, Kan Hing Mak, Wing Cheung Wong |
Journal | Journal of orthopaedic surgery (Hong Kong)
(J Orthop Surg (Hong Kong))
Vol. 23
Issue 2
Pg. 174-9
(Aug 2015)
ISSN: 2309-4990 [Electronic] England |
PMID | 26321544
(Publication Type: Journal Article)
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Chemical References |
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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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