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

Tani, Satoshi; Suetsua, Futoshi; Mizuno, Junichi; Uchikado, Hisaaki; Nagashima, Hiroyasu; Aoki, Masahiko; Isoshima, Akira; Ohashi, Hiroki; Hirano, Yoshitaka; Abe, Toshiaki

doi:10.2176/nmc.50.1132

Cited by 26 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are many reports of “new method” of laminoplasty in the literature, but the basic technique to expand the spinal canal falls into either Hirabayashi’s open-door technique with a hinge on one side or Kurokawa’s double-door technique with hinges on both sides. Many modifications were also developed to keep the expanded lamina from being closed, for example by using sutures, 3 , 11) autologous bone grafts, 4 , 13) hydroxyapatite or other ceramic materials, 14 , 15) titanium miniplates 16) or spacers, 17) allograft and titanium plates, 18) and hydroxyapatite and screws. 19) …”

Section: Historymentioning

confidence: 99%

Cervical Laminoplasty: The History and the Future

Kurokawa

Kim

2015

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Cervical laminoplasty was developed as an alternative to cervical laminectomy for treatment of cervical myelopathy, in which hinges are created to lift the lamina. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi’s open-door laminoplasty and Kurokawa’s spinous process splitting (double-door) laminoplasty. Several in vitro studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. In clinical situation, randomized control studies are scarce and superiority of one procedure over another is not uniformly shown. Lack of hard evidence supporting the purported advantages of laminoplasty over laminectomy, that is, reduced rate of postoperative instability and kyphosis development, while preserving range of motion (ROM), has been a weak selling point. Currently, laminoplasty is performed by majority of spine surgeons in Japan, but is rarely performed in the United States and Europe. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck ROM exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM seems minimal. Well-designed clinical trials to show the effectiveness and long-term outcome of this surgical procedure are warranted.

show abstract

Section: Historymentioning

confidence: 99%

Cervical Laminoplasty: The History and the Future

Kurokawa

Kim

2015

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…17) Hyperostosis around HA spacers may cause stenosis of the spinal canal and exacerbation of neurological symptoms. Although this titanium spacer with two arms has not been legally approved yet in Japan, this design seems to be very useful for both unilateral and bilateral opendoor laminoplasty.…”

Section: Discussionmentioning

confidence: 99%

Cervical Unilateral Open-Door Laminoplasty With Titanium Miniplates Through Newly Designed Hydroxyapatite Spacers -Technical Note-

Tanaka

Tashiro

Gomi

et al. 2011

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A newly designed hydroxyapatite (HA) spacer for cervical laminoplasty is provided with a hole through which the titanium miniplate is passed. A new method of unilateral open-door laminoplasty with titanium miniscrew and miniplate through this HA spacer is described. Twenty-two patients with cervical stenotic disorders were treated by this procedure. Only the predominantly affected side of the laminae is exposed. The supraspinous and interspinous ligaments and the deep muscle layer in the contralateral side are left intact. A 4-mm wide gutter near the intervertebral joint is made and contralateral hinges are made under the deep muscle layer with minimum detachment of these muscles. The opened lamina is fixed with the titanium miniplate passed through the hole in the newly designed HA spacer. Mean operative time for the 22 operations was 193.5 minutes. Mean enlargement of the minimum spinal canal diameter was 50.9%. Neurological outcomes after 3 months were evaluated according to the Japanese Orthopaedic Association (JOA) scoring. Mean recovery rate of JOA score by Hirabayashi's method was 49.5%. Only 2 patients reported postoperative axial neck pain. Our method for unilateral open-door laminoplasty provides adequate decompression and tight fixation of laminae, and is less invasive to the posterior supporting elements of cervical spine.

show abstract

“…Various materials are used to maintain the enlarged spinal canal such as thread 3) , autogeneous bone (spinous process 4,5) , iliac bone 2,6) ), hydroxyapatite spacer [7][8][9][10][11][12][13][14][15][16][17] , and titanium plate and screw 18,19) . Double-door type was first developed by Kurokawa in the late 1970s and reported in 1982 2) .…”

Section: Introductionmentioning

confidence: 99%

Recent Surgical Methods of Double-door Laminoplasty of the Cervical Spine (Kurokawa's Method)

Hirabayashi

2018

Spine Surg Relat Res

View full text Add to dashboard Cite

Abstract:Introduction: Double-door laminoplasty (DDL) of the cervical spine (Kurokawa's method) was developed as one of posterior decompression surgical methods in the late 1970s and after then has been modified by adding various procedures such as the posterior muscle handling and the use of artificial spacers.There are three principles of DDL: First, to decompress the cervical spinal cord by central splitting of the spinous processes and laminae, preserving those lengths as much as possible and widening the spinal canal space symmetrically. Second, to maintain the widened spinal canal space steadily by fixing spacers made of hydroxyapatite the contour is almost the same as the widened space. Third, to re-suture the semispinalis muscles to the C2 spinous process to restore the strength of the posterior cervical muscles.Technical note: The important technical points in performing osteotomy are as follows: At each vertebra, osteotomy is performed from the caudal side and gradually proceeds to the cranial side because there is a space between the lamina and the dura mater at the caudal side and the osteotomy can be safely made. The surgeon must pay attention to the changes in color of the osteotomy site from red of cancellous bone, to white of the inner cortex, and finally to yellow of the yellow ligament and extradural fat tissue. Attention must be paid to the changes in sound and tactile sensation delivered from the air-drill when completing osteotomy of the inner cortex of lamina. By moving an air-drill slowly, tactile sensation can be more sensitive. During osteotomy, the process must be checked frequently by touching the inner cortex of the lamina with a probe.Conclusion: At present, DDL is a useful surgical method for cervical myelopathy at multiple level lesions.

show abstract

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

Cited by 26 publications

References 29 publications

Cervical Laminoplasty: The History and the Future

Cervical Laminoplasty: The History and the Future

Cervical Unilateral Open-Door Laminoplasty With Titanium Miniplates Through Newly Designed Hydroxyapatite Spacers -Technical Note-

Recent Surgical Methods of Double-door Laminoplasty of the Cervical Spine (Kurokawa's Method)

Contact Info

Product

Resources

About