Clinical and radiography results of mini-plate fixation compared to suture suspensory fixation in cervical laminoplasty: A five-year follow-up study

Chen, Hua; Deng, Yuxiao; Li, Tao; Gong, Qiyong; Song, Yueming; Liu, Hao

doi:10.1016/j.clineuro.2015.09.004

Cited by 31 publications

(35 citation statements)

References 25 publications

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“…These were used in the laminoplasty to construct a complete laminar arch and avoid the secondary narrowing of the spinal canal and neurological deterioration over the long-term follow-up. [11–14] …”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

Zhang²,

B³

et al. 2016

Medicine

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Background:Piezosurgery is a relatively new osteotomy technique using microvibrations of scalpels at ultrasonic frequencies to perform safe and effective osteotomies without damage to adjacent soft tissue, which is widely used in spinal, oral, and maxillofacial surgery. We hypothesized that such a device could also be useful in cervical laminoplasty. The purpose of this study was to compare the safety and efficacy of a piezosurgery device with those of a highspeed drill in cervical laminoplasty.Methods:A prospectively randomized clinical study was designed. Forty-two consecutive patients were enrolled in the study. All patients underwent modified expansive open-door laminoplasty and were randomly divided into 2 groups according to the instrument for transection of the lamina, using high-speed drill (drill group) or piezosurgery device (piezosurgery group). The operation time, intraoperative blood loss, and postoperative drainage were recorded. Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) as clinical assessments were quantified.Results:No significant difference was observed in the operation time between the 2 groups. In the piezosurgery group, there were less loss of the intraoperative blood and postoperative drainage compared with the drill group. However, clinical results (VAS and JOA scores) showed no significant difference between both groups during the all follow-up periods.Conclusion:The piezosurgery is a useful instrument and at least as safe and efficacious as the conventional high-speed drill in cervical laminoplasty.

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

Zhang²,

B³

et al. 2016

Medicine

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“…[ 6 – 10 ] The plated cervical laminoplasty has the advantages like maintaining opened lamina position rigidly, preventing lamina reclosure, preserving more cervical range of motion (ROM) and cervical curvature, allowing early return to cervical exercise, and promoting hinge bony fusion compared to classic cervical laminoplasty. [ 11 , 12 ] In plated cervical laminoplasty, miniplates were anchored to lateral masses and opened laminae by miniscrews. However, the complications associated with internal fixation in plated cervical laminoplasty are rarely discussed in literatures.…”

Section: Introductionmentioning

confidence: 99%

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

Chen

Wang

et al. 2016

Medicine

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A retrospective cohort study. Plated cervical laminoplasty is an increasingly common technique. A unique facet joint disturbance induced by lateral mass miniscrews penetrating articular surface was noticed. Facet joints are important to maintain cervical spine stability and kinetic balance. Whether this facet joint disturbance could affect clinical and radiologic results is still unknown. The objective of this study is to investigate the clinical and radiologic outcomes of patients with facet joints disturbance induced by miniscrews in plated cervical laminoplasty.A total of 105 patients who underwent cervical laminoplasty with miniplate fixation between May 2010 and February 2014 were comprised. Postoperative CT images were used to identify whether facet joints destroyed by miniscrews. According to facet joints destroyed number, all the patients were divided into: group A (none facet joint destroyed), group B (1–2 facet joints destroyed), and group C (≥3 facet joints destroyed). Clinical data (JOA, VAS, and NDI scores), radiologic data (anteroposterior diameter and Palov ratio), and complications (axial symptoms and C5 palsy) were evaluated and compared among the groups.There were 38, 40, and 27 patients in group A, B, and C, respectively. The overall facet joints destroyed rate was 30.7%. All groups gained significant JOA and NDI scores improvement postoperatively. The preoperative JOA, VAS, NDI scores, and postoperative JOA scores did not differ significantly among the groups. The group C recorded significant higher postoperative VAS scores than group A (P = 0.002) and B (P = 0.014) and had significant higher postoperative NDI scores than group A (P = 0.002). The pre- and postoperative radiologic data were not significant different among the groups. The group C had a significant higher axial symptoms incidence than group A (12/27 vs 8/38, P = 0.041).Facet joints disturbance caused by miniscrews in plated cervical laminoplasty may not influence neurological recovery and spinal canal expansion, but may negatively affect postoperative axial symptoms.

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“…30 Anatomically, the space between the spinous processes of C2 and C3 is relatively narrow compared to others due to anatomical peculiarity of C2 spinous process, which may lead to bony impingement between the spinous processes of C2 and C3 during motion of the neck, especially after C3 laminoplasty which caused posteriorly shifted arch of C3. Miniplate could provide rigid support, wider open angle, and larger anteroposterior diameter of the vertebral canal compared with suture suspension 12,23 ; therefore, in the C3/ C5 group, the plated C3 lamina could exacerbate the impingement that might result in limited motion and cervical malalignment.…”

Section: Discussionmentioning

confidence: 99%

The impact of plating level on the postoperative loss of cervical lordosis in alternative skipped-level plating laminoplasty

Lin

Huang

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: The aim of this study is to evaluate the impact of plating level on the loss of cervical lordosis (LCL) after laminoplasty with skipped-level plating. Methods: This retrospective study included patients who underwent alternative skipped-level plating laminoplasty from C3 to C6. Patients were divided into two groups according to the plating level. Group 1 had miniplate fixed at C3 and C5 (C3/C5 group), while patients in group 2 were fixed at C4 and C6 (C4/C6 group). The outcome of interest was the difference of LCL between the two groups; meanwhile, kyphosis development after laminoplasty was also compared. Results: A total of 70 patients were included in our study with a mean age of 60.44 ± 9.97 years. The median follow-up was 15 (12, 16) months. Median lordosis was 15.43° (9.35°, 22.23°) before surgery and 9.88° (4.15°, 18.94°) after, with a median LCL of 4.48° (−0.66°, 8.11°). There were 17 patients in the C3/C5 group, whereas 53 patients in the C4/C6 group. While preoperative C2–C7 Cobb’s angle was comparable between the two groups (15.32° (9.73°, 23.84°) vs. 15.51° (9.03°, 21.70°), p = 0.864), there were statistical differences regarding postoperative C2–C7 Cobb’s angle (6.54° (2.49°, 16.42°) vs. 10.62° (5.89°, 18.85°), p = 0.006) and LCL (4.74° (4.17°, 12.03°) vs. 4.07° (−1.89°, 6.69°), p = 0.034) between the C3/C5 group and the C4/C6 group. In all, 94.1% (16 of 17) of patients showed some degree of LCL after laminoplasty in the C3/C5 group, which was significantly higher when compared with 64.2% (34 of 52) of C4/C6 group ( p = 0.038). Before surgery, there were no kyphosis patients in either the C3/C5 group or the C4/C6 group. Postoperatively, four patients (23.5%) developed kyphotic alignment in the C3/C5 group, but only one (1.9%) in the C4/C6 group ( p = 0.013). Conclusions: Cervical alignment was compromised after laminoplasty. When alternative skipped-level plating is adopted in laminoplasty from C3 to C6, plating at C4/C6 may better preserve cervical lordosis than plating at C3/C5 after surgery.

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Clinical and radiography results of mini-plate fixation compared to suture suspensory fixation in cervical laminoplasty: A five-year follow-up study

Cited by 31 publications

References 25 publications

Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

Facet joint disturbance induced by miniscrews in plated cervical laminoplasty

The impact of plating level on the postoperative loss of cervical lordosis in alternative skipped-level plating laminoplasty

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