Open-door Cervical Expansile Laminoplasty

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Michael Y. Wang ◽  
Barth A. Green
Keyword(s):  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Extensive Experience ◽  
Canal Stenosis

Abstract CERVICAL LAMINOPLASTY IS becoming a popular technique for the treatment of cervical myelopathy that is the result of multilevel canal stenosis. Many variations in this technique, which was originally created in Japan, have been developed, all with the goal of increasing canal space and reconstructing the posterior bony arch. We describe our extensive experience with this procedure for the treatment of cervical spondylotic myelopathy.

OPEN-DOOR EXPANSILE CERVICAL LAMINOPLASTY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-154-S1-159 ◽  
Author(s):  
Elizabeth Vitarbo ◽  
Rishi N. Sheth ◽  
Allan D. Levi
Keyword(s):  
Surgical Technique ◽  
Spinal Stenosis ◽  
Cervical Myelopathy ◽  
Outcome Data ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Cervical Spinal Stenosis ◽  
Current Article

Abstract OPEN-DOOR EXPANSILE laminoplasty is a practical surgical technique for the treatment of cervical myelopathy secondary to cervical spinal stenosis. Laminoplasty procedures were first described in the late 1970s and have undergone numerous modifications. The current article reviews the indications, techniques, and outcome data for cervical laminoplasty. Complications of laminoplasty and comparison to laminectomy outcomes are also discussed.

Achondroplasia and cervical laminoplasty

2009 ◽  
Vol 11 (4) ◽  
pp. 417-420 ◽  
Author(s):  
June Yoshii ◽  
Vincent C. Traynelis
Keyword(s):  
Surgical Treatment ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Adult Woman ◽  
Segmental Motion ◽  
Cervical Laminoplasty ◽  
Canal Stenosis

Achondroplasia is associated with short pedicles that predispose individuals with this trait to develop symptomatic spinal canal stenosis. Laminoplasty is an excellent means of treating cervical myelopathy due to stenosis in selected individuals. Laminoplasty preserves segmental motion and stability, both of which are of benefit to all individuals. The authors report the successful surgical treatment of an achondroplastic adult woman with laminoplasty. This procedure alleviated her symptoms, and she was doing well at 2-year follow-up.

scholarly journals Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Brett A. Braly ◽  
David Lunardini ◽  
Chris Cornett ◽  
William F. Donaldson
Keyword(s):  
Surgical Technique ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Technical Difficulty ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Clinical Signs And Symptoms

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

scholarly journals A Prospective, Randomized Trial Comparing Expansile Cervical Laminoplasty and Cervical Laminectomy and Fusion for Multilevel Cervical Myelopathy

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. 264-277 ◽  
Author(s):  
Glen R. Manzano ◽  
Gizelda Casella ◽  
Michael Y. Wang ◽  
Steven Vanni ◽  
Allan D. Levi
Keyword(s):  
Range Of Motion ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Cervical Laminoplasty ◽  
Japanese Orthopedic Association Score ◽  
Association Score ◽  
Japanese Orthopedic Association ◽  
Canal Area ◽  
Cervical Laminectomy ◽  
Laminectomy And Fusion

Abstract BACKGROUND: Controversy exists as to the best posterior operative procedure to treat multilevel compressive cervical spondylotic myelopathy. OBJECTIVE: To determine clinical, radiological, and patient satisfaction outcomes between expansile cervical laminoplasty (ECL) and cervical laminectomy and fusion (CLF). METHODS: We performed a prospective, randomized study of ECL vs CLF in patients suffering from cervical spondylotic myelopathy. End points included the Short Form-36, Neck Disability Index, Visual Analog Scale, modified Japanese Orthopedic Association score, Nurick score, and radiographic measures. RESULTS: A survey of academic North American spine surgeons (n = 30) demonstrated that CLF is the most commonly used (70%) posterior procedure to treat multilevel spondylotic cervical myelopathy. A total of 16 patients were randomized: 7 to CLF and 9 to ECL. Both groups showed improvements in their Nurick grade and Japanese Orthopedic Association score postoperatively, but only the improvement in the Nurick grade for the ECL group was statistically significant (P < .05). The cervical range of motion between C2 and C7 was reduced by 75% in the CLF group and by only 20% in the ECL group in a comparison of preoperative and postoperative range of motion. The overall increase in canal area was significantly (P < .001) greater in the CLF group, but there was a suggestion that the adjacent level was more narrowed in the CLF group in as little as 1 year postoperatively. CONCLUSION: In many respects, ECL compares favorably to CLF. Although the patient numbers were small, there were significant improvements in pain measures in the ECL group while still maintaining range of motion. Restoration of spinal canal area was superior in the CLF group.

Cervical Laminoplasty Construct Stability: A Finite Element Study

2008 ◽  
Author(s):  
Srinivas C. Tadepalli ◽  
Nicole A. Kallemeyn ◽  
Kiran H. Shivanna ◽  
Joseph Smucker ◽  
Douglas C. Fredericks ◽  
...  
Keyword(s):  
United States ◽  
Finite Element ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
The United States ◽  
Cervical Laminoplasty ◽  
Finite Element Study ◽  
Multi Level ◽  
Laminectomy And Fusion ◽  
Element Study

Cervical laminoplasty is one of many modern techniques utilized in the management of cervical myelopathy. In the United States cervical spondylotic myelopathy (CSM) has been classically treated with multilevel decompression and fusion. Furthermore, multi-level anterior cervical decompression and fusion (ACDF), via disectomies or corpectomies, and multi-level cervical laminectomy and fusion have been well described [1]. In the last decade cervical laminoplasty has grown in popularity as a non-fusion alternative that allows multi-level cervical decompression.

Does developmental canal stenosis influence surgical results of bilateral open-door laminoplasty for cervical spondylotic myelopathy?

2008 ◽  
Vol 9 (4) ◽  
pp. 358-362 ◽  
Author(s):  
Hideki Shigematsu ◽  
Yurito Ueda ◽  
Munehisa Koizumi ◽  
Toshichika Takeshima ◽  
Yasuhito Tanaka ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Clinical Results ◽  
Surgical Results ◽  
Open Door ◽  
Negative Group ◽  
Canal Stenosis ◽  
Significant Difference ◽  
High Incidence ◽  
Developmental Canal Stenosis ◽  
Male Patients

Object The purpose of this study was to investigate the prevalence of developmental canal stenosis in patients with cervical spondylotic myelopathy (CSM), and the correlation between surgical results and degree of developmental canal stenosis. Methods A total of 112 patients who eventually had surgical treatment for CSM were evaluated. Male patients whose sagittal spinal diameter was < 14 mm and females whose sagittal diameter was < 13 mm even at one level were classified as having developmental canal stenosis. Two groups of patients were used in this study; the “positive” group (57 cases) included patients with developmental canal stenosis preoperatively, whereas the “negative” group (55 cases) excluded such patients. Lateral functional radiographs obtained in patients in the 2 groups were compared for range of motion and clinical results. Results Developmental canal stenosis was found in 50.9% of all cases. Based on clinical results, there was no significant difference between the 2 groups. Conclusions Patients with CSM showed a high incidence of preoperative developmental canal stenosis. However, there were no significant differences in clinical results between patients with and without this disorder. These results indicate that developmental canal stenosis is not a factor that influences surgical results.

Neuropsychological Improvement in Patients with Cervical Spondylotic Myelopathy after Cervical Laminoplasty

2009 ◽  
Vol 23 (2) ◽  
pp. 305-306
Author(s):  
Minoru Hoshimaru ◽  
Schun-ichi Kihara ◽  
Toru Koizumi ◽  
Hiroyuki Yukawa ◽  
Shigeo Ueda ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Laminoplasty

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

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.

The Anatomical and Biomechanical Superiority of Novel Posterior En Bloc Elevation Cervical Laminoplasty

2021 ◽  
pp. 155335062098465
Author(s):  
Dong-Lai Wang ◽  
Guo-Qing Zhu ◽  
An-Quan Huang ◽  
Hong Zhang ◽  
Chuan Feng ◽  
...  
Keyword(s):  
Biomechanical Testing ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Lateral Bending ◽  
En Bloc ◽  
Cross Sectional ◽  
Expansion Pattern ◽  
Intact Condition ◽  
Axial Symptoms ◽  
The Common

Objectives. In this study, we performed a novel type of posterior en bloc elevation cervical laminoplasty (PEEL) to keep the integrity of the posterior structure, aiming to reduce axial symptoms complicated by a conventional cervical laminoplasty procedure. Methods. Twelve human cervical cadaveric spines (C2-T1) were sequentially tested in the following order: intact condition, open-door laminoplasty (ODL) through bilateral intermuscular approach (mini-invasive ODL), PEEL, and laminectomy (LN). After bilateral transecting at the junction of lamina and lateral mass through the tubular retraction system, the PEEL procedure symmetrically elevated all the posterior structure which was further stabilized with bone grafts and titanium plates. Computed tomography (CT) scan and biomechanical testing were performed after each condition. Results. Both mini-invasive ODL and PEEL procedures were accomplished with 2 small incisions on each side. Two types of laminoplasties could enlarge the spinal canal significantly both in cross-sectional area and anteroposterior diameter comparing with intact condition. The PEEL procedure demonstrated a significantly higher enlargement rate on a canal area and a symmetrical expansion pattern. Compared with intact condition, mini-invasive ODL performed from C3-C7 demonstrated significantly decreased motion in all testing directions except the flexion range of motion (ROM); the PEEL procedure showed mild and insignificant decrease on ROM in all directions. Laminectomy resulted in a statistically significant increase in all directions except the lateral bending ROM. Conclusions. Posterior en bloc elevation cervical laminoplasty can enlarge the canal more effectively and preserve better ROM after operation than the ODL procedure. Although technically challenging, the PEEL procedure probably would decrease the common complications associated with ODL laminoplasty.

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