250 - En Bloc Cervical Laminoplasty Using Trans-laminar Screw (T-laminoplast...

#250 En Bloc Cervical Laminoplasty Using Trans-laminar Screw (T-laminoplasty): New Procedure of Cervical Laminoplasty

Cervical Therapies and Outcomes

Poster Presented by: S. Lee

Author(s):

S.E. Lee (1)
T.-A. Jahng (1)

(1) Seoul National University College of Medicine, Seoul, Korea, Republic of

Abstract

Background: Cervical laminoplasty is a popular surgical procedure for patients with multilevel compressive cervical lesions. However, several reports have noted its limitations and shortcomings.

Objective: The authors have newly developed an en bloc cervical laminoplasty procedure using a trans-laminar screw to preserve the posterior midline structures so as to maintain spinal stability and prevent postoperative axial pain and deformity.

Methods: In brief, after standard exposure of posterior cervical spine with preserving the midline ligamentous structure, en bloc laminotomy was made. The trans-laminar trajectory from the lamina to the contralateral lateral mass was prepared. Then, a long trans-laminar screw was inserted through the lamina with suspension of the laminotomized block to expand the spinal canal, passed through the allograft laminar spacer, and finally was inserted in the contralateral lateral mass. Next, using the same method a following screw was inserted to the adjacent segment from the opposite side; further screw fixations were made using this alternating fashion.

Results: The levels of laminoplasty totaled 83 in 20 patients. C3-C6 laminoplasty was the most common (11 patients). Clinical outcomes were statistically improved during the mean follow-up period of 14.2 months. Radiologic outcomes of cervical lordosis and range of motion were preserved with expansion of the cross-sectional area of the spinal canal.

Conclusion: En bloc cervical laminoplasty using trans-laminar screw can be a surgical option for multilevel compressive cervical lesions. With this novel procedure, it was possible to preserve the midline ligamentous structures while obtaining good clinical and radiologic outcomes.