Outcome of the Expansive Open-door Laminoplasty with Titanium Miniplate in Cervical Stenosis

ABSTRACT

OBJECTIVE: The purpose of this study is to introduce a simple yet effective technique to secure the posterior elements in the open position after expansive open-door laminoplasty and to evaluate factors contributing to surgical results after laminoplasty. METHODS: Twenty two myelopathic or radiculopathic patients with multilevel cervical canal stenosis or ossification of the posterior longitudinal ligament were treated with an expansive open-door laminoplasty. Thirteen patients were cervical spinal stenosis and the other 9 patients were diagnosed as the ossification of the posterior longitudinal ligament. The posterior elements were stabilized in the open position with titanium miniplates without spacers. Morphometric analysis was performed on preoperative and postoperative plain radiographs to obtain spinal canal dimensions and to monitor construct integrity. RESULTS: The mean preoperative sagittal canal diameter was 10.3+/-2.2mm. These dimensions increased to 17.4+/-2.8mm after surgery. Most patients improved from the myelopathy or the radiculopathy and the mean recovery rate was 52.4+/-17.1%. The titanium miniplate constructs did not fail during the follow-up period (mean, 38.5 months) and the decompression was maintained. Serious complications such as instability and kyphosis did not develop in any cases. There were no significant factors that predict surgical outcome. CONCLUSION: Expansive open-door laminoplasty using titanium miniplates can be easily performed and is effective technique for decompression and maintenance of the spinal canal diameter.