Korean J Spine.  2014 Sep;11(3):152-156. 10.14245/kjs.2014.11.3.152.

Box-Shape Cervical Expansive Laminoplasty: Clinical and Radiological Outcomes

• Park HG
• Zhang HY
• Lee SH

• KMID: 1885671
• DOI: http://doi.org/10.14245/kjs.2014.11.3.152

Abstract

OBJECTIVE
Box-shape cervical expansive laminoplasty is a procedure that utilizes a Miniplate(R) or Maxpacer(R) to achieve maximal canal expansion. This method is expected to show much larger canal expansion and good clinical outcome. So we investigated the clinical and radiological outcome of Box-shape cervical expansive laminoplasty.
METHODS
Between June 2008 and July 2013, we performed cervical expansive laminoplasty in 87 and 48 patients using the Box-shape cervical expansive laminoplasty, respectively. We analyzed the clinical results of these operations using the Japanese Orthopedic Association (JOA) scoring system and by assessing the position of intralaminar screws with postoperative computed tomography (CT) at POD-6 months.
RESULTS
A total of 48 patients with ossification of the posterior longitudinal ligament (OPLL) (36 pts), cervical spondylotic myelopathy (CSM) (12 pts) were enrolled. Overall JOA scores improved from 11.49 to 14.22 at POD-6 months (OPLL: 11.32 -->14.3; CSM: 12-->14). Postoperative CT scans were performed in 39 patients at 177 levels for a total of 354 screws. The malpositioning rate of intralaminar screws was 3.4% and hardware-related neurologic complications did not occur.
CONCLUSION
Box-shape cervical expansive laminoplasty creates maximal spinal canal expansion and leads to improved cervical myelopathy. The use of intralaminar screws to fix the remodeled lamina-facet does not represent a significant difficulty.

Keyword

Open door laminoplasty; Double door laminoplasty; Intralaminar screw; Spinal canal area; Box-shape laminoplasty

MeSH Terms

Asian Continental Ancestry Group
Humans
Longitudinal Ligaments
Orthopedics
Spinal Canal
Spinal Cord Diseases
Tomography, X-Ray Computed