Expansive Laminoplasty for Cervical Myelopathy With Interconnected Porous Calcium Hydroxyapatite Ceramic Spacers

Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Fujimoto, Yoshinori; Sasaki, Hirofumi; Kamei, Naosuke; Hamasaki, Takahiko; Yamada, Kiyotaka; Yamamoto, Risako; Nakamae, Toshio; Ochi, Mitsuo

doi:10.1097/bsd.0b013e31815c85bd

Cited by 42 publications

(46 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the spinous processes positioned obliquely after decompression, open-door laminoplasty is susceptible to result in axial pain [31]. Therefore, successful reconstruction of the laminae of vertebral arches is essential, because sinking or nonunion of the expanded laminae can induce postoperative axial pain [43]. In addition, detaching of the muscles from C2 or C7 has been regarded as another possible cause of postoperative axial pain [13,41].…”

Section: Discussionmentioning

confidence: 99%

“…Only one study [14] compared the postoperative axial pain between laminectomy and laminoplasty approaches, indicating that laminoplasty was associated with less late axial pain. Other surgical techniques such as reconstruction of the spinous process-ligament-muscle complex [24], threadwire T-saw laminoplasty [2], en bloc laminoplasty without dissection of paraspinal muscles [8] and expansive laminoplasty with various kinds of spacers [43] were beneficial in reducing the incidence of axial pain. These studies, however, had no control groups and/or no validated measures of assessment of axial pain.…”

Section: Surgical Techniquementioning

confidence: 99%

See 1 more Smart Citation

Axial pain after posterior cervical spine surgery: a systematic review

et al. 2010

View full text Add to dashboard Cite

Posterior operative approach has been the standard treatment for cervical compressive myelopathy, and axial pain after laminoplasty or laminectomy as a postoperative complication is now gradually receiving more and more attention. The objective of this study was to provide a systematic review of the current understanding of axial pain after cervical laminoplasty and laminectomy, and summarize clinical features, influence factors and preventive measures of axial pain after posterior decompressive surgery based on a review of literature published in the English language. Axial pain distributes over nuchal, periscapular and shoulder regions. Posterior surgery is not the major cause of axial pain, but axial pain can be worsened by the procedure. There are many clinical factors that influence postoperative axial pain such as age, preoperative axial pain, different surgical technique and postoperative management, but most of them are still controversial. Several surgical modifications have been innovated to reduce axial pain. Less invasive surgery, reconstruction of the extensor musculature, avoiding detachment of the semispinalis cervicis muscle and early removal of external immobilization have proved to be effective. Axial pain is under the influence of multiple factors, so comprehensive methods are required to reduce and avoid the postoperative axial pain. Because of methodological shortcomings in publications included in this systematic review, different results from different studies may be produced due to differences in study design, evaluation criteria, sample size, and incidence or severity of axial pain. More high-quality studies are necessary for drawing more reliable and convincing conclusions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

Axial pain after posterior cervical spine surgery: a systematic review

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Compression was detected in the C3-4, C4-5, and/or C5-6 level on MRI. All patients underwent cervical laminoplasty, 35 and some exhibited neurological improvement. Orthopedic surgeons who did not perform laminoplasty obtained the Japanese Orthopaedic Association (JOA) score for cervical myelopathy 8 as a clinical measure (total of 17 points possible) before surgery and 1 year after surgery.…”

Section: Methodsmentioning

confidence: 99%

Electrophysiological evidence of functional improvement in the corticospinal tract after laminoplasty in patients with cervical compressive myelopathy

Nakanishi¹,

Tanaka²,

Kamei³

et al. 2014

SPI

Self Cite

View full text Add to dashboard Cite

Object Cervical laminoplasty is a surgical procedure for cervical compressive myelopathy (CCM), and satisfactory outcomes have been reported. However, few reports have examined the pathophysiology of improvements in spinal cord function. The aim of this study was to investigate the variation in central motor conduction time (CMCT) before and after cervical laminoplasty in patients with CCM. Methods Motor evoked potentials (MEPs) following transcranial magnetic stimulation and compound muscle action potentials (CMAPs) and F-waves following electrical stimulation of the ulnar and tibial nerves at the wrist and ankle were measured from the abductor digiti minimi muscle (ADM) and abductor hallucis muscle (AH) in 42 patients with CCM before and 1 year after cervical laminoplasty. The peripheral conduction time (PCT) was calculated as follows: (latency of CMAPs + latency of F-waves − 1)/2. The CMCT was calculated by subtracting the PCT from the onset latency of the MEPs. The CMCT recovery ratio was defined and calculated as the ratio of CMCT values 1 year after surgery to those before surgery. The CMCT data were analyzed as longer or shorter CMCT between the patients' right and left ADMs and AHs. The Japanese Orthopaedic Association (JOA) score for cervical myelopathy was obtained as a clinical outcome before and 1 year after surgery. The recovery rate (RR) 1 year after surgery was calculated using the following formula: (postoperative JOA score 1 year after surgery – preoperative JOA score)/(17 – preoperative JOA score) × 100. Correlations among CMCT parameters, patient age, JOA score, and RR were determined. Results The longer and shorter CMCTs from the ADM (longer, p = 0.000; shorter, p = 0.008) and the longer CMCT from the AH (longer, p = 0.000) before surgery decreased significantly 1 year after surgery; the shorter CMCT from the AH did not significantly differ (shorter, p = 0.078). The mean JOA score before surgery was 10.1 ± 3.0 and improved significantly to 12.9 ± 2.7 at 1 year after surgery (p = 0.000). The mean CMCT recovery ratio and RR were 0.91 ± 0.18 and 0.43 ± 0.27, respectively. The longer/shorter CMCT parameters in the ADM and AH before or 1 year after surgery correlated significantly with the JOA score both before and 1 year after surgery. The CMCT recovery ratio from the longer CMCT in the ADM correlated significantly with the RR (r = − 3090, p = 0.011). There were no significant correlations between age and any CMCT parameters or CMCT recovery ratios. Conclusions These results suggest that cervical laminoplasty improves corticospinal tract function 1 year after surgery, which may be one of the reasons for the JOA score improvements in patients with CCM. The degree of improvement in corticospinal tract function did not correlate with patient age in this case series. The results demonstrated quantitative evidence of the pathophysiology of functional recovery in the corticospinal tract following cervical laminoplasty in patients with CCM.

show abstract

“…4,9,26) Artificial spacers seem to be essential elements to support the elevated laminae, so many types of hydroxyapatite (HA) spacers are made commercially to provide stabilization of the expanded laminar arch. 8,11,16,17,19,21,[29][30][31] However, HA spacers have the disadvantages of lower plasticity and implant-related complications, such as breakage or occasional difficulty in tightening by sutures, that can result in loosening of the spacers. [13][14][15]23) Novel techniques in laminoplasty with titanium miniplates have been used in cranial surgery.…”

Section: Introductionmentioning

confidence: 99%

New Titanium Spacer for Cervical Laminoplasty: Initial Clinical Experience -Technical Note-

Tani

Suetsua²,

Mizuno³

et al. 2010

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Many commercially available hydroxyapatite (HA) spacers for cervical laminoplasty have been introduced but have disadvantages such as lack of plasticity, easy cracking, and occasional difficulty in fixation by sutures. Here we present the short-term results of a newly designed titanium spacer (Laminoplasty Basket) in open-door cervical laminoplasty, and evaluated clinically and radiologically. The titanium box-shaped spacer with two arms for fixation was easily inserted and fixed into the laminoplasty space with 4-mm or 5-mm length screws after the posterior cervical arch was repositioned for the canal expansion. Twenty-one patients with cervical myelopathy due to spondylosis or ossification of the longitudinal ligament or developmental narrow canal observed for more than 6 months postoperatively were enrolled in this study. The neurological condition of these patients improved from 9.4 points on the Japanese Orthopaedic Association scale preoperatively to 13.5 points at 6 months after surgery. Postoperative radiological evaluation showed no laminar closure or implant failure and cervical spine curvature was maintained. These results seemed to have no significant difference compared with those using HA spacers. This titanium spacer is a potential substitute for conventional HA or other similar devices in cervical laminoplasty.

show abstract

Expansive Laminoplasty for Cervical Myelopathy With Interconnected Porous Calcium Hydroxyapatite Ceramic Spacers

Cited by 42 publications

References 16 publications

Axial pain after posterior cervical spine surgery: a systematic review

Axial pain after posterior cervical spine surgery: a systematic review

Electrophysiological evidence of functional improvement in the corticospinal tract after laminoplasty in patients with cervical compressive myelopathy

New Titanium Spacer for Cervical Laminoplasty: Initial Clinical Experience -Technical Note-

Contact Info

Product

Resources

About