Evaluation of Open Door Expansile Laminoplasties Using Titanium Miniplates for Treatment of Cervical Stenosis.
Jongsoo
Park, MD
J. Patrick Johnson, MD
Chinyere Obasi, MBBS FRCSC (Los Angeles, CA)
Introduction: Simple laminectomies of cervical spine has the potential to cause progressive kyphotic deformity, and decompressive laminoplasties are an effective alternative treatment for myeloradiculopathy caused by spinal stenosis. The effect of decompression by laminoplasties is comparable to that of laminectomies, while the laminoplasties may preserve stuctural integrity and avoid multilevel fusion. A retrospective outcome evaluation from 3 years experience was analysed.
Methods: Multilevel open door expansile laminoplasties were performed using titaninum miniplates and autograft bone on 20 subjects between 1997–99. The laminoplasties were performed on average of 2.8 levels (C3–TI). Foraminotomies were performed at symptomatic levels. Average follow–up was 15 months (3–30 months). Indications were cervical myeloradiculopathy caused by spondylosis, congenital stenosis and OPLL with or without foramenal stenosis. All patients had minimal neck pain, lordosis or straight alignment. Average operating room time was 2.8 hours and hospital stay was 3.2 days. All patients were placed in a cervical collar for 30–90 days.
Results: All patients reported improvement of symptoms with 60% reporting resolution of myelopathy and the remainder had partial improvements. There were no operative complications and no kyphotic deformities occurred.
Conclusion: Laminoplasties have become feasible and effective procedure for treatment of cervical myeloradiculopathy using titanium miniplates for stabilization of open lamimae. The short–term results are encouraging, however, long term outcomes are needed.