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

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.