Laminar reclosure after single open-door laminoplasty using titanium miniplates versus suture anchors

Laminar closure is associated with expansive open-door laminoplasty. Suture anchor fixation and titanium miniplate fixation are used to prevent laminar reclosure. However, few studies have compared the clinical effects of the 2 fixation methods. The authors performed a prospective study of 55 patients with cervical spondylotic myelopathy who underwent single open-door laminoplasty with suture anchor fixation (n=30) or titanium miniplate fixation (n=25) from June 2005 to May 2011. Clinical and radiologic outcomes were evaluated at 1 week and 1 year postoperatively. There were no significant differences between the 2 groups in terms of Japanese Orthopaedic Association (JOA) scores, JOA recovery rates at 1 week postoperatively, and the incidence of C5 palsy. Compared with the suture anchor group, the recovery rate in the titanium miniplate group was significantly higher at 1 year postoperatively, and the incidence of axial symptoms and mean axial symptom scores were significantly lower at 1 week, but not 1 year, postoperatively. Radiologic examination showed no significant differences in the anteroposterior diameter of the spinal cord and the vertebral body-to-spinal cord distance between the 2 groups. At 1 year postoperatively, the opening angle in the suture anchor group was significantly less than that in the titanium miniplate group. Titanium miniplate fixation is more effective than suture anchor fixation in preventing laminar closure, accompanied by a higher JOA recovery rate at 1-year follow-up and a lower incidence of axial symptoms.