Short-Term Clinical Evaluation of Enhanced Unilateral Open-Door Laminoplasty Using Titanium Mesh

Wicaksono, Adiguno Suryo; Manusubroto, Wiryawan

Abstract

STUDY DESIGN: Observational, cross-sectional study. PURPOSE: The purpose of this study was to evaluate the clinical efficacy and safety profile of open-door laminoplasty (ODL) using titanium mesh. OVERVIEW OF LITERATURE: The most appropriate surgical management of degenerative spine disorders, particularly ossification of the posterior longitudinal ligament, remains controversial and continues unabated in the neurosurgical community. However, recently, ODL has become popular among surgeons. Many modifications have been developed since Hirabayashi in 1983 to enhance the clinical efficacy and safety of this procedure.
METHODS
We reviewed the obtained data of patients with ossification of the posterior longitudinal ligament (OPLL) who underwent ODL using titanium mesh at Neurosurgery Subdivision, the Dr. Sardjito Hospital, Yogyakarta, Indonesia, during January 2013-December 2015. Motor improvement (Nurick score), axial neck pain (neck disability index [NDI]), and incidence of complications were pre- and postoperatively examined, and the clinical efficacy and safety of the procedure was evaluated. Data were analyzed using Wilcoxon signed-rank test and paired t-test.
RESULTS
This study included five patients were included (i.e., four males and one female) with mean age of 47.00±9.68 years, where reassessments were done after mean follow up of 20.2±4.74 months. Mean duration of surgery was 165±12.55 minutes. Pre- and postoperative motor assessments were 3.4±1.52 and 2.0±1.22 (p =0.059), respectively. Axial neck pains using NDI were 23.60±7.44 and 12.40±6.50 (p =0.004) before and after operations, respectively. No infected postoperative scar was found, and only one patient had a left C5 motor palsy.
CONCLUSIONS
The results of the present study suggest that enhanced ODL using titanium mesh has favorable outcome and safety profile, which can pave the way for a suitable treatment in patients with OPLL.