Union Rate on Hinge Side after Open-Door Laminoplasty Using Maxillofacial Titanium Miniplate

Abstract

Background. One of the important complications of open-door laminoplasty is a premature laminoplasty closure. In order to prevent premature laminoplasty closure many techniques have been described and a titanium miniplate is one of the instruments to maintain cervical canal expansion. This study was performed to evaluate the effectiveness of titanium miniplates on the union rate for open-door laminoplasty. Materials and Methods. We performed open-door laminoplasty in 68 levels of fourteen patients using maxillofacial titanium miniplates. Axial computed tomography scans were obtained at 6 months postoperatively to evaluate the union rates of the hinge side. The Japanese Orthopedic Association (JOA) score was used to compare the clinical outcomes before and after surgery. Results. Computed tomography scan data was available on 68 levels in 14 patients. There were no premature closures of the hinge or miniplate dislodgements. The union rate on the hinge side was 70.5% (48/68). The mean JOA score increased significantly from 7.0 before surgery to 10.2, 12.2, and 13.0 after surgery at 1, 3, and 6 months, respectively. Conclusion. Open-door laminoplasty using maxillofacial titanium miniplates can provide union rates comparable to other techniques. It can maintain canal expansion without failures, dislodgements, and premature closures.

Safety and efficacy of cervical laminoplasty using a piezosurgery device compared with a high-speed drill

“…As surgical techniques are continuously being improved and surgical devices become increasingly fine, the rate of good surgical efficacies continues to improve while surgical time, blood loss, and relevant complications decrease. [ 25 , 27 , 28 ]…”

Preoperative Factors Affecting Postoperative Axial Symptoms After Single-Door Cervical Laminoplasty for Cervical Spondylotic Myelopathy: A Prospective Comparative Study

“…The facet joints should be held intact to prevent the incidence of post-AS. Second, miniplate fixation reduces the micro-movements and muscle stimuli caused by nonunion hinge more effectively than suture fixation, because miniplates provide immediate rigidity of fixation, and better stabilization of the cervical spine, and increase the union on the hinge side [21]. A report also indicated that hinge nonunion might be a risk factor of post-AS after cervical laminoplasty [12].…”

Expansive Open-Door Cervical Laminoplasty

“…As surgical techniques are continuously being improved and surgical devices become increasingly fine, the rate of good surgical efficacies continues to improve while surgical time, blood loss, and relevant complications decrease. 11 , 12 However, after operations a variety of symptoms remain or occur, including neck and shoulder pain, stiffness, and limited neck motion. 13 We believe that expansive open-door cervical laminoplasty creates a relative large injury and will cause damage of the ligament complex to various degrees when relaxing pressure.…”