418 - A Modified Unilateral Open-door Laminoplasty Using Hydroxyapatite Lami...

Oral Posters: Cervical

Presented by: S.-H. Kim - View Audio/Video Presentation (Members Only)

Author(s):

S.-H. Kim(1), S.-W. Jin(1), S.-H. Lee(1), B.-J. Kim(1), S.-K. Ha(1), S.-D. Kim(1), D.-J. Lim(1)

(1) Korea University Ansan Hospital, Department of Neurosurgery, Ansan, Korea, Republic of

Abstract

Introduction: Cervical laminoplasty has been widely accepted as one of the major treatments for cervical myelopathy and various modifications and supplementary procedures have been devised to achieve both proper decompression and stability of the cervical spine. The use of hydroxyapatite (HA) in the field of spinal syrgery is increasing because of the good biocompatibility, safety, and osteoconductive capability of the material. We present the retrospectively analyzed results of a modified unilateral open-door laminoplasty using HA spacers and malleable titanium miniplates.

Material and Methods: From June 2008 to Feb 2013, among patients diagnosed with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament, the patients who received laminoplasty were reviewed. Clinical outcome was assessed using Frankel grade and Japanese Orthopaedic Association score. The radiologic parameters were obtained from plain films, 3-dimensional computed tomography and magnetic resonance images.

Results: A total of 166 cervical laminae were operated in 50 patients. 16 patients received 4-level laminoplasty and 34 patients received 3-level laminoplasty. Postoperatively, the mean Frankel grade and JOA score were significantly improved from 3.97 to 4.55 and from 12.76 to 14.63, respectively (P < 0.001). Radiologically, cervical curvature was worsened from 19.09 to 15.60 (p=0.025). The percentage of range of motion preservation was 73.32 ± 22.39%. The axial dimension of the operated spinal canal was increased from 1.75 to 2.70 cm2 (p< 0.001).

Conclusions: In our study, unilateral open-door laminoplasty using HA spacers and miniplates appears to be a safe, rapid and easy procedure to obtain an immediate and rigid stabilization of the posterior elements of the cervical spine. This modified laminoplasty method showed effective expansion of the spinal canal and favorable clinical outcomes.

Keywords: Cervical Vertebrae, Laminoplasty, Spinal Cord Compression, ossification of posterior longitudinal ligament, Hydroxyapatites