Effect of Mini-plate Fixation on Hinge Fracture and Bony Fusion in Unilateral Open-door Cervical Expansive Laminoplasty

Abstract

Centerpiece mini-plate fixation in unilateral open-door cervical expansive laminoplasty might not increase the complete fracture rate compared with suture suspension and might promote bony fusion of type I complete hinge fractures.

Double-door cervical laminoplasty with suture anchors: evaluation of the clinical performance of the constructs

“…First, this technique has a low risk of lamina collapse into the spinal canal, which could lead to nerve root or spinal cord injury. Chen et al evaluated 287 laminae with CT after cervical laminoplasty with a mini-plate, and reported that 3.7 % of the laminae collapsed into the cervical canal [8]. However, in the present study, only one case of lamina collapse (0.4 %) was identified.…”

“…In the present technique, the yellow ligament beneath the hinge is strained as the laminae are secured in the maximum open position, and it is considered that the strained yellow ligament prevents lamina collapse into the spinal canal [8]. Additionally, hinge fracture did not have a negative effect on bony fusion, although previous reports demonstrated that it was a significant factor for fusion failure [8,23]. This might be because the opened lamina is fixed firmly with the strained yellow ligament together with the suture anchor, even in complete hinge fracture.…”

“…Later, various materials were used to keep the laminae open, such as autologous bone, mini-plates, and ceramic spacers [6]. Furthermore, several studies have investigated bony healing after laminoplasty [7][8][9].…”

Comparison between Radiological and Clinical Outcomes of Laminoplasties with Titanium Miniplates for Cervical Myelopathy

“…EOLP is advantageous over laminectomy and fusion in terms of the preservation of cervical movement and posterior structures and reduction of adjacent segment disease 456). However, disadvantages of the technique include posterior neck pain, C5 nerve root palsy, and laminar reclosure after surgery 789101112).…”

Three-dimensional Printed Patient-specific Drilling Templates for Expansive Open-door Laminoplasty

“…Complete hinge fracture was supposed to be related to the lamina displacement into the spinal canal, which might compress the spinal cord or encroach the nerve root causing neurological deterioration. [5] In short, we believed that using the drilling templates could help the surgeon prepare the open-side and hinge-side troughs more safely.…”