Short-Term Clinical Evaluation of Enhanced Unilateral Open-Door Laminoplasty Using Titanium Mesh

Abstract

Study DesignObservational, cross-sectional study.PurposeThe purpose of this study was to evaluate the clinical efficacy and safety profile of open-door laminoplasty (ODL) using titanium mesh.Overview of LiteratureThe most appropriate surgical management of degenerative spine disorders, particularly ossification of the posterior longitudinal ligament, remains controversial and continues unabated in the neurosurgical community. However, recently, ODL has become popular among surgeons. Many modifications have been developed since Hirabayashi in 1983 to enhance the clinical efficacy and safety of this procedure.MethodsWe reviewed the obtained data of patients with ossification of the posterior longitudinal ligament (OPLL) who underwent ODL using titanium mesh at Neurosurgery Subdivision, the Dr. Sardjito Hospital, Yogyakarta, Indonesia, during January 2013–December 2015. Motor improvement (Nurick score), axial neck pain (neck disability index [NDI]), and incidence of complications were pre- and postoperatively examined, and the clinical efficacy and safety of the procedure was evaluated. Data were analyzed using Wilcoxon signed-rank test and paired t-test.ResultsThis study included five patients were included (i.e., four males and one female) with mean age of 47.00±9.68 years, where reassessments were done after mean follow up of 20.2±4.74 months. Mean duration of surgery was 165±12.55 minutes. Pre- and postoperative motor assessments were 3.4±1.52 and 2.0±1.22 (p =0.059), respectively. Axial neck pains using NDI were 23.60±7.44 and 12.40±6.50 (p =0.004) before and after operations, respectively. No infected postoperative scar was found, and only one patient had a left C5 motor palsy.ConclusionsThe results of the present study suggest that enhanced ODL using titanium mesh has favorable outcome and safety profile, which can pave the way for a suitable treatment in patients with OPLL.

Comparison of the operative time for open door laminoplasty using titanium plate spacers or hydroxyapatite block spacers: a retrospective study

“…To our knowledge, this is the first study to have directly compared the operative time between the use of TP and HA spacers in open-door laminoplasty. Previous studies have reported an operative time of 112–160 min for HA spacers [19–21], compared to 90–181 min for TP spacers [22–26]. However, as these were single-arm descriptive studies of either procedure without direct comparison, the benefit of TP spacers on operative time could not be confirmed.…”

The role of sacral laminoplasty in the management of spina bifida and sacral cystic lesions: case series

“…In addition, cervical laminoplasty with titanium mesh has also been reported recently as a novel and safe technique. 15 Regarding the use of titanium mesh in the developing spines of pediatric patients, in children older than 10 years of age, sacral instrumentation with screws and rods has been reported as a standard procedure with an instrumentation failure rate as low as 1.3%. 7 In a younger child, the spinal canal grows to approximately 90% of its definitive size by age 3-5 years.…”