Expansive open-door laminoplasty with titanium miniplate versus sutures.

Abstract

Expansive laminoplasty is an effective treatment for cervical myelopathy. Since the design of classic open-door laminoplasty with the use of suture, the procedure has been modified to reduce complications such as restenosis, axial symptoms, and segmental motor paralysis. Expansive open-door laminoplasty with the use of titanium miniplate is becoming popular. It is effective in expanding spinal canal dimensions with good clinical efficacy. However, a lack of studies exist comparing titanium miniplate fixation with classical suture fixation.We performed a retrospective study of 54 patients with cervical myelopathy. Twenty-nine patients (4 women and 25 men) receiving expansive open-door laminoplasty by titanium miniplate fixation were classified as the modified group, and 25 patients (5 women and 20 men) fixed with suture served as the control group. Clinical and radiologic outcomes were assessed. No significant differences were observed in Japanese Orthopaedic Association scores and the recovery rate of C5 palsy. The incidence of axial symptoms in the modified group was significantly lower than that in control group. Radiologic examination showed that postoperative C2-C7 lordosis and range of motion of the cervical spine in the modified group were preserved. No significant differences were observed in mean anteroposterior diameter and open angle in the 2 groups. Both surgical protocols were effective in preventing reclosure of open laminae. Furthermore, the modified laminoplasty was superior in reducing the incidence of axial symptoms and loss of cervical lordosis and range of motion.