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Modified Open-door Laminoplasty Using Hydroxyapatite Spacers and Miniplates.

Sung-Won Jin1, Se-Hoon Kim1, Bum-Joon Kim1

  • 1Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

Korean Journal of Spine
|October 28, 2014
PubMed
Summary

This study shows that a modified unilateral open-door laminoplasty with hydroxyapatite spacers and miniplates effectively decompresses the cervical spinal canal. The procedure improved patient outcomes and provided rigid stabilization, making it a safe and rapid surgical option.

Keywords:
Bone platesCervical vertebraeHydroxyapatitesOssification of posterior longitudinal ligamentSpinal cord compression

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Cervical laminoplasty is a key treatment for cervical myelopathy.
  • Modifications aim to enhance decompression and spinal stability.
  • Hydroxyapatite (HA) spacers and titanium miniplates offer potential benefits.

Purpose of the Study:

  • To evaluate the clinical and radiological outcomes of a modified unilateral open-door laminoplasty.
  • To assess the efficacy of using HA spacers and malleable titanium miniplates for cervical spine stabilization.

Main Methods:

  • Retrospective analysis of 38 patients undergoing modified unilateral open-door laminoplasty (June 2008 - May 2012).
  • Inclusion criteria: cervical spondylotic myelopathy and ossification of posterior longitudinal ligament.
  • Outcomes assessed using Frankel grade, Japanese Orthopaedic Association (JOA) score, and radiological parameters (plain films, 3D CT, MRI).

Main Results:

  • Significant improvement in mean Frankel grade (3.97 to 4.55) and JOA score (12.76 to 14.63) (p<0.001).
  • Mean cervical curvature worsened (19.09 to 15.60) (p=0.025), with 73.32% range of motion preservation.
  • Significant increase in spinal canal axial dimension (1.75 to 2.70 cm²) (p<0.001).

Conclusions:

  • Modified unilateral open-door laminoplasty with HA spacers and miniplates is a safe, rapid, and effective procedure.
  • Achieves immediate and rigid stabilization of posterior cervical elements.
  • Demonstrates effective spinal canal expansion and favorable clinical outcomes.