Prediction of Spinal Canal Expansion Following Cervical Laminoplasty: A Computer-Simulated Comparison Between Single and Double-Door Techniques

Wang, Xiangyang; Dai, Li-Yang; Xu, Huazi; Chi, Yong-Long

doi:10.1097/01.brs.0000245851.55012.f1

Cited by 35 publications

(34 citation statements)

References 27 publications

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“…In such cases, traction, tethering, and/or kinking of the nerve root secondary to posterior shift of the spinal cord may result, which has been viewed as a main factor in postoperative C5 nerve root palsy [13][14][15][16][17][18]. Wang et al [19] pointed out that excessive opening creates a wider epidural space, leading to excessive formation of epidural scar tissue. Although the laminoplasty opening size (LOS) largely determines the amount of canal expansion created during laminoplasty, but the relationship between the LOS and the amount of canal expansion has remained unclear.…”

Section: Introductionmentioning

confidence: 99%

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Gu¹,

Zhang

Shen

et al. 2015

Eur Spine J

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Objective To clarify the relationship between the laminoplasty opening size (LOS), the laminoplasty opening angle (LOA) and the increase in sagittal canal diameter (SCD) and to predict the amount of canal enlargement during open-door cervical laminoplasty (ODCL). Methods Formula describing the relationship between LOS and LOA, the increase in SCD was deduced. The parameters of pre-and postoperative computed tomography scans of 36 patients who had undergone laminoplasty surgery were measured by picture archiving and communication system (PACS) software, and the amount of canal enlargement of these patients was predicted when the opening size of laminoplasty was 8, 10, 12, 14 and 16 mm according to the formula. Results For equivalent LOS, the amount of canal enlargement with each opening size differed throughout the cervical region. When the C3-C7 LOS was 10 mm the SCD increased [4.1 mm, and the canal area increased in C3-C6 [88 mm 2 , and the canal area increased in C7 [ 80 mm 2 .When the C3-C7 LOS was 12 mm, the SCD increased [5.2 mm, and the canal area increased in C3-C6 [104 mm 2 , and the canal area increased in C7 [ 94 mm 2 . Conclusion Formula accurately showed the relationship between the LOS and the increase in SCD achieved by ODCL. The amount of canal enlargement following ODCL could be predicted by the formula. LOS of 10-12 mm at C3-C7 might be optimal during ODCL.

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Section: Introductionmentioning

confidence: 99%

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Gu¹,

Zhang

Shen

et al. 2015

Eur Spine J

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show abstract

“…Other authors have also expressed the idea that excessive opening of the lamina may lead to post-operative C5 nerve root palsy [16,17]. Wang et al [18] pointed out that excessive opening also creates a wider epidural space and leads to the formation of more epidural scar tissues than normally expected.…”

Section: Discussionmentioning

confidence: 99%

The relationship between laminoplasty opening angle and increased sagittal canal diameter and the prediction of spinal canal expansion following double-door cervical laminoplasty

Zhang

Shen

et al. 2014

Eur Spine J

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Purpose To clarify the relationship between laminoplasty opening angle (LOA) and the increase in sagittal canal diameter (SCD) in double-door cervical laminoplasty (DDCL) and to predict the increase in SCD using the resulting formula. Methods We analyzed 20 patients with multilevel cervical spondylotic myelopathy who underwent DDCL between September 2010 and January 2013. The pre-and post-operative parameters of the cervical spinal canal were measured by computed tomography. We deduced a formula describing the relationship between LOA and the increase in SCD and used it to predict the increase in SCD of these patients as LOA increased. Results When the C3-C7 LOA was 25°-45°, the magnitude of the increase in SCD was notable (increases of 3.08-5.6 mm compared with the pre-operative SCD). When the C3-C7 LOA was more than 45°, the magnitude of the increase in SCD was relatively smaller; the increase in C3-C7 SCD with a 55°LOA was merely 0.4 mm more than with a 45°LOA. When LOA was 30°at C3-C6 or 40°a t C7, the increase in SCD was more than 4 mm. When the C3-C6 LOA was 40°, SCD increased by more than 5 mm. ConclusionsThe formula accurately showed the relationship between LOA and the increase in SCD in DDCL. Based on the LOA, increases in SCD following C3-C7 laminoplasty can be accurately predicted using this formula. This enables DDCL based on accurate individual LOAs, which prevents inadequate or excessive opening.

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“…In addition, a few studies have reported laminoplasty using computer-assisted analysis. Wang and colleagues [5] studied canal expansion with both single open-door laminoplasty and double open-door laminoplasty using a computer-assisted technique. They concluded that the increased amount of canal following laminoplasty could be predicted by regression equations.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from the width of the bone gutter (d), the angle of the lifted lamina () is of crucial importance for clinical outcomes of EL since it is closely linked with canal enlargement [5]. Clinically, studies have shown that neurologic improvement directly correlates with the degree of canal expansion.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative design of expansive open-door laminoplasty: A computer-assisted morphometric analysis

Wang

Gao

et al. 2013

Computer Aided Surgery

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Whereas the expansive open-door laminoplasty (EL) has been applied widely and the bone gutter on the hinge side is essential for EL, little is known regarding the mandatory width of the bone gutter. This study addressed the essential parameters of bone gutters for EL. Preoperative axial CT images of 20 patients suffering from cervical myelopathy were downloaded and entered into a computer. EL was then simulated using a computer-assisted technique and the thickness of the laminae at the gutter sites was measured. Accordingly, the width of the bone gutter was linked mathematically with the angle of the lifted lamina and the thickness of the lamina at the lamina-lateral mass junction. Furthermore, the average thickness of the laminae at the gutter site was 6.19 mm, and the appropriate bone gutter for EL was 5.13 to 7.15 mm. The width of the bone gutter can thus be planned precisely preoperatively, which may help improve the safety and accuracy of expansive open-door laminoplasty.

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Prediction of Spinal Canal Expansion Following Cervical Laminoplasty: A Computer-Simulated Comparison Between Single and Double-Door Techniques

Cited by 35 publications

References 27 publications

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

Relationship between the laminoplasty opening size and the laminoplasty opening angle, increased sagittal canal diameter and the prediction of spinal canal expansion following open-door cervical laminoplasty

The relationship between laminoplasty opening angle and increased sagittal canal diameter and the prediction of spinal canal expansion following double-door cervical laminoplasty

Preoperative design of expansive open-door laminoplasty: A computer-assisted morphometric analysis

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