Initial radiological findings utilizing titanium basket for cervical open door laminoplasty

Area of Science:

• Spine surgery
• Neurosurgery
• Orthopedic surgery

Background:

• Cervical laminoplasty is a standard surgical procedure in Japan for treating ossification of the posterior longitudinal ligament (OPLL) and cervical spondylotic myelopathy (CSM).
• Traditional methods use various spacers to maintain an open lamina during surgery.
• A novel titanium 'basket' spacer (Laminoplasty Basket: L-Basket) was developed to facilitate bony fusion while keeping the lamina open.

Purpose of the Study:

• To evaluate the efficacy and safety of the novel titanium L-Basket spacer in open-door cervical laminoplasty.
• To assess the potential for bony fusion across the open lamina and hinge side using the L-Basket.
• To analyze clinical outcomes and complications associated with this technique.

Main Methods:

• Open-door cervical laminoplasty was performed on 27 patients using the L-Basket spacer.
• Patients had either OPLL or CSM.
• Preoperative and postoperative Japanese Orthopaedic Association (JOA) scores were collected, along with radiographic (X-ray, CT) assessments at least 12 months postoperatively.

Main Results:

• Significant improvement in JOA scores from 10.3 preoperatively to 14.8 at 3 months postoperatively.
• Radiographic evidence of fusion was observed on the open side (62%) and hinge side (90.2%) at 12 months.
• Circumferential fusion occurred in 59.8% of patients; one patient experienced transient C5 palsy, with no other major complications.

Conclusions:

• The titanium L-Basket spacer effectively promotes bone union between the spacer, lamina, and lateral masses after cervical laminoplasty.
• This technique allows for 'door open' laminoplasty while facilitating bony fusion.
• The L-Basket spacer is associated with good clinical outcomes and a low complication rate in treating OPLL and CSM.