Effect of Mini-plate Fixation on Hinge Fracture and Bony Fusion in Unilateral Open-door Cervical Expansive Laminoplasty

Abstract ObjectiveThis retrospective study aimed to investigate the clinical and radiographic outcomes of open-door laminoplasty with modified centerpiece mini-plate fixation and extensor attachment point reconstruction for treating cervical spondylotic myelopathy (CSM).MethodSixty-nine patients with CSM, who underwent C3-7 open-door laminoplasty in our hospital from January 2016 to May 2017, were divided into two groups: group A underwent surgery with a modified centerpiece titanium plate and group B underwent surgery with a conventional centerpiece titanium plate. Changes in cervical spinal angle (CSA), cervical range of motion (ROM), atrophy of posterior cervical muscles, and neurological function (Japanese Orthopaedic Association [JOA] score) and the occurrence of axial symptoms (AS) were compared between the groups.ResultThere were no significant differences in operative time, intra-operative blood loss, lamina open angle, and spinal cord drift distance between the groups. After the surgery, JOA score significantly increased (P < 0.05), neurological recovery rates were similar (62.7% vs. 63.4%), cervical ROM did not significantly change when compared with the preoperative level (P > 0.05) in both groups; CSA and cross-sectional area of the posterior cervical muscles decreased significantly in group B (P < 0.05) but not in group A (P > 0.05), and postoperative AS were significantly more severe in group B than in group A (P < 0.05).ConclusionOpen-door laminoplasty is an effective surgical procedure for CSM. The application of modified centerpiece mini-plate fixation effectively reconstructs the posterior extensor attachment points, which reduces posterior cervical muscle atrophy, maintains cervical curvature, and reduces the occurrence of axial symptoms.

Download Full-text

A New Posterior Extensor Attachment-Point Reconstruction Technique for Cervical Spondylotic Myelopathy Involving C2 Segment: Clinical Outcome and Safety

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0040-1719102 ◽

2020 ◽

Author(s):

Hai-Yun Yang ◽

Yun-Ge Zhang ◽

Dong Zhao ◽

Gui-Ming Sun ◽

Yi Ma ◽

...

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Plate Fixation ◽

Japanese Orthopaedic Association ◽

Neurological Dysfunction ◽

Reconstruction Technique ◽

Open Door ◽

Titanium Plate ◽

Attachment Point ◽

Curvature Index ◽

Axial Symptoms

Abstract Background and Study Aim Cervical spondylotic myelopathy (CSM) is a common degenerative disease that mainly occurs in elder patients, leading to different degrees of neurological dysfunction. Spinal cord involvement is mainly distributed at the C3–C7 segments, but it may also involve up to the C2 level. This study aimed to assess the clinical efficacy and safety of open-door laminoplasty using a new extensor attachment-point reconstruction technique for treating CSM involving the C2 segment. Patients and Methods Fifty-nine patients with CSM involving the C2 segment and undergoing open-door laminoplasty were included in this retrospective study. Based on the titanium plate used in the operation, patients were divided into two groups, a reconstructed titanium plate fixation (RPF) group (n = 28) and a conventional titanium plate fixation (CPF) group (n = 31). Improvements in neurological function, cervical range of motion (ROM), cervical curvature index (CCI), preservation of posterior cervical muscle mass, and axial symptoms were compared between the two groups. Results There were no significant differences in operative time and intraoperative blood loss between the groups (p > 0.05). The Japanese Orthopaedic Association (JOA) score significantly increased in both groups postsurgery (p < 0.05); the neurological recovery rate was similar between the two groups (64.1 ± 13.3% vs. 65.9 ± 14.7%, p > 0.05). There was no significant loss of cervical ROM in either group (p > 0.05). The anteroposterior dural sac diameter at the C2 level was significantly enlarged in both groups (p < 0.05). Alternatively, CCI was significantly reduced in the CRP group (p < 0.05) but unchanged in the RPF group (p > 0.05). The cross-sectional area of the posterior cervical muscles was also significantly reduced in the CPF group (p < 0.05) but maintained in the RPF group (p > 0.05). Finally, axial symptoms were more severe in the CPF group than in the RPF group (p < 0.05). Conclusion Laminoplasty is an effective surgical procedure for CSM involving the C2 segment. The reconstructed titanium plate achieved superior maintenance of cervical curvature and reduced both muscle atrophy and severity of axial symptoms compared with titanium conventional plates.

Download Full-text

All levels versus alternate levels plate fixation in expansive open door cervical laminoplasty

Indian Journal of Orthopaedics ◽

10.4103/0019-5413.144225 ◽

2014 ◽

Vol 48 (6) ◽

pp. 582 ◽

Cited By ~ 14

Author(s):

Hui-Lin Yang ◽

Jun Qian ◽

Zheng-Fei Wang ◽

Guang-Dong Chen ◽

Feng Xue ◽

...

Keyword(s):

Plate Fixation ◽

Cervical Laminoplasty ◽

Open Door

Download Full-text

FIXATION OF AN ULNODORSAL FRAGMENT WHEN TREATING AN INTRA-ARTICULAR FRACTURE IN THE DISTAL RADIUS

Hand Surgery ◽

10.1142/s0218810414970016 ◽

2014 ◽

Vol 19 (01) ◽

pp. 139-144 ◽

Cited By ~ 7

Author(s):

Kazuo Ikeda ◽

Naoki Osamura ◽

Kaoru Tada

Keyword(s):

Distal Radius ◽

Surgical Procedure ◽

Plate Fixation ◽

Volar Plate ◽

Dorsal Approach ◽

Articular Fracture ◽

Low Profile ◽

Volar Plate Fixation ◽

Mini Plate

If fixation of an ulnodorsal fragment in an intra-articular fracture of the distal radius is not stable, it is sometimes caused by dorsal displacement after surgery. Hence, we recommend the volar plate fixation with an additional dorsal approach and fixation of irreducible ulnodorsal fragments using a low-profile dorsal mini plate. The details of the surgical procedure and indications are discussed in this article.

Download Full-text

Arthroscopy Mini-plate Fixation with the Posterior Trans-septal Portal for Treating Posterior Cruciate Ligament Tibial Avulsion Fractures

10.21203/rs.3.rs-116153/v1 ◽

2020 ◽

Author(s):

Chunlei Wang ◽

Haisen Zhang ◽

Longjie Li ◽

Si Chen ◽

Chang Liu

Keyword(s):

Posterior Cruciate Ligament ◽

Plate Fixation ◽

Cruciate Ligament ◽

International Knee Documentation Committee ◽

Fracture Site ◽

Avulsion Fractures ◽

Conventional Open Surgery ◽

Mini Plate ◽

Pcl Avulsion

Abstract Background Posterior cruciate ligament (PCL) avulsion fractures are rare and difficult to treat. The present work aimed to examine the effect of an innovative arthroscopy method for the treatment of PCL tibial avulsion fractures using mini-plate reduction and fixation through two tibial tunnels and the posterior trans-septal portal.Methods Totally 19 patients (median age, 33 years; range, 23–43 years) with PCL tibial avulsion fractures who underwent treatment with an arthroscopic suture bridge method were retrospectively assessed. Knee function pre-operation and at last follow up was assessed via Lysholm and Tegner scores. A KT-2000 arthrometer was employed for determining knee stability, the range of motion (ROM), and side-to-side differences. Plain radiography and International Knee Documentation Committee (IKDC) exams were performed for patient evaluation.Results No patient was switched to conventional open surgery due to difficult intraoperative procedures. Mean post-surgical Lysholm and Tegner scores (P < 0.001) were significantly improved in comparison with presurgical values. KT-2000 examination revealed markedly reduced side-to-side differences at last follow-up than observed preoperatively (1.2 ± 0.6 VS. 9.3 ± 2.2; P < 0.001). Radiography at the final follow up revealed solid union at the fracture site in the totality of 19 cases.Conclusions This new arthroscopy mini-plate fixation and posterior trans-septal method for posterior cruciate ligament tibial avulsion fractures resulted in good clinico-radiological outcomes, with adequate stability and fracture site healing. It could be employed to repair avulsion fragments of various sizes.Level of evidence IV

Download Full-text