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Midline-Splitting Open Door Laminoplasty Using Hydroxyapatite Spacers : Comparison between Two Different Shaped

Jin Hoon Park1, Sang Ryong Jeon

  • 1Department of Neurological Surgery, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Korea.

Journal of Korean Neurosurgical Society
|September 21, 2012
PubMed
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The wingless hydroxyapatite (HA) spacer demonstrated a higher fusion rate in laminoplasty compared to the winged type. Clinical outcomes were similar between the two HA spacer designs.

Area of Science:

  • Spine surgery
  • Biomaterials
  • Orthopedic research

Background:

  • Hydroxyapatite (HA) spacers are utilized in laminoplasty for cervical myelopathy.
  • Limited data exists on factors influencing fusion and the impact of HA spacer shape on outcomes.

Purpose of the Study:

  • To investigate the factors associated with fusion after laminoplasty using HA spacers.
  • To evaluate the effect of HA spacer shape (winged vs. wingless) on fusion rates and clinical outcomes.

Main Methods:

  • A cohort of 45 patients with compressive cervical myelopathy underwent laminoplasty using winged or wingless HA spacers.
  • Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score.
  • Radiographic analysis included cervical lordosis, canal dimensions, and fusion assessment via X-ray and CT scans.
Keywords:
Cervcial myelopathyFusion rateHydroxyapatiteLaminoplastyMidline splittingShape

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Main Results:

  • No significant differences in clinical outcomes (JOA scores) or radiographic changes (lordosis, canal dimension) were observed between winged and wingless HA groups.
  • The wingless HA group exhibited a significantly higher fusion rate (48.8%) compared to the winged HA group (18.2%) at 12 months post-operatively (p=0.001).
  • Multivariate analysis identified ossification of the posterior longitudinal ligament, male gender, and wingless HA type as significant predictors of fusion.

Conclusions:

  • While clinical outcomes are comparable, the wingless HA spacer design promotes superior fusion between the lamina and the implant at 12 months post-surgery.
  • The findings suggest that HA spacer geometry plays a role in achieving solid fusion in laminoplasty procedures.