Surgical Technique and Long-term Follow-up of Cervical Laminoplasty using Titanium Miniplates.

Jeon, Seong Cheol; Chough, Chung Kee; Park, Hae Kwan; Lee, Kyung Jin; Rha, Hyung Kyun; Kim, Moon Chan

Original Article

Journal of Korean Neurosurgical Society 2004;36(5): 369-374.

Seong Cheol Jeon, Chung Kee Chough, Hae Kwan Park, Kyung Jin Lee, Hyung Kyun Rha, Moon Chan Kim

Department of Neurosurgery, Catholic Neuroscience Center, The Catholic University of Korea, Seoul, Korea. chough@catholic.ac.kr

ABSTRACT

OBJECTIVE
The authors report a simple and reliable method for cervical open-door laminoplasty secured by titanium miniplate. METHODS: Sixteen patients with cervical myelopathy secondary to multilevel cervical spondylosis or ossification of the posterior longitudinal ligament were treated with an expansive open-door laminoplasty using titanium miniplates to stabilize the posterior elements described by O'Brien et al between February 1998 and June 2002, and all had a minimum of 6 months of follow-up(mean 22.5months) review. Plain radiographs were used to measure sagittal canal diameter and monitor construct integrity. The neurological outcome was evaluated before and after operation using the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. RESULTS: Only 1 titanium miniplate construct was failed out of 69 levels in 16 patients during follow-up period, but decompression was maintained. After surgery, in 15 patients(93.7%) different levels of clinical improvement were demonstrated, and in four of them(25%) full recovery was observed. The sagittal canal diameter and JOA score increased from 13.3+/-2.2mm and 9.19 preoperatively to 20+/-2.4mm and 12.88 postoperatively(p<0.01). CONCLUSION: The use of titanium miniplate to stabilize the posterior elements after laminoplasty is a simple, durable, and effective technique to maintain the increased sagittal canal diameter of the spinal canal and have another advantage of compatability of magnetic resonance imaging.

Key Words: Laminoplasty; Titanium miniplate; Surgical technique; Cervical myelopathy