Essential Surgical Technique for French-Door (Double-Door) Laminoplasty.

Nakashima, Hiroaki; Imagama, Shiro; Ito, Zenya; Ando, Kei; Yagi, Hideki; Ishikawa, Yoshimoto; Ishiguro, Naoki; Kato, Fumihiko · JBJS Essent Surg Tech · 2015

expert_opinion · Level V

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Abstract

We describe the surgical technique and the pitfalls of French-door laminoplasty. Position the patient to keep the cervical spine "parallel to the floor" or in the "reverse Trendelenburg position" with only a slight incline and place intraoperative neurological monitors to prevent intraoperative neurological deterioration. Use the common cervical posterior approach to expose the lamina and ligamentum flavum. Cut the center of each lamina and create bilateral grooves using a high-speed burr. Open the lamina bilaterally and create a small hole in each one using a high-speed burr. Create bone struts from the spinous processes and tie them to each lamina. Perform meticulous closure of the wound to avoid wound-healing complications. In our original study<sup>12</sup>, we treated forty-six patients with French-door laminoplasty and compared the surgical results of this procedure with those of open-door laminoplasty in a prospective, randomized controlled manner.IndicationsContraindicationsPitfalls & Challenges.