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New titanium spacer for cervical laminoplasty: initial clinical experience. Technical note.
Satoshi Tani1, Futoshi Suetsua, Junichi Mizuno
1Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan.
Neurologia Medico-Chirurgica
|January 6, 2011
Summary
A novel titanium spacer for cervical laminoplasty offers a promising alternative to hydroxyapatite (HA) spacers. This new device demonstrated effective canal expansion and neurological improvement in patients with cervical myelopathy.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Biomaterials Science
Background:
- Commercially available hydroxyapatite (HA) spacers for cervical laminoplasty present limitations including poor plasticity, cracking, and fixation challenges.
- These limitations necessitate the development of improved spacer materials and designs for enhanced cervical spine surgery outcomes.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of a newly designed titanium spacer (Laminoplasty Basket) in open-door cervical laminoplasty.
- To assess the safety and efficacy of the titanium spacer as a substitute for conventional HA spacers.
Main Methods:
- A box-shaped titanium spacer with fixation arms was utilized in 21 patients undergoing open-door cervical laminoplasty.
- The spacer was secured using 4-mm or 5-mm screws following posterior cervical arch repositioning for canal expansion.
- Patients with cervical myelopathy were followed for over 6 months, with clinical assessment using the Japanese Orthopaedic Association scale and radiological evaluation.
Main Results:
- Significant neurological improvement was observed, with Japanese Orthopaedic Association scores increasing from 9.4 preoperatively to 13.5 at 6 months postoperatively.
- Radiological assessment revealed no instances of laminar closure or implant failure, and maintenance of cervical spine curvature.
- Outcomes showed no significant difference compared to patients treated with HA spacers.
Conclusions:
- The newly designed titanium spacer is easily inserted and fixed, demonstrating effective canal expansion and neurological improvement in cervical laminoplasty.
- The titanium spacer shows comparable safety and efficacy to HA spacers, presenting a viable alternative for cervical laminoplasty procedures.
- This titanium device offers a potential substitute for conventional HA or similar spacers, addressing limitations of current materials.