Cervical open-door laminoplasty technique with simple sutures and bone grafts: a single institutional study with 30 consecutive cases

Abstract

BACKGROUND: Expansive open-door laminoplasty is widely accepted as a reliable procedure for cervical myelopathy. However, one acknowledged complication is spring-back complication or closure of the door which may result in restenosis of cervical canal and neurologic deterioration. The study aimed for addressing our cervical open-door laminoplasty technique with sutures and bone grafts and subsequently the follow-up outcomes. METHODS: Thirty consecutive patients who underwent open-door laminoplasty with the novel technique were included and followed for minimum 5 years from Jan 2006 to Dec 2007. Anteroposterior diameter (APD) of the vertebral canal of C4 was measured in lateral cervical radiographs. Neurologic scenarios were noted using the Japanese Orthopaedic Association (JOA) scores. RESULTS: Twenty-five males (83.3%) and five (16.7%) females with an average follow-up of 68 months were enrolled. The preoperative APD was 13.22 mm (+/-1.15), whereas the postoperative APD increased to 31.23 mm (+/-2.43) with an expansion ratio of 136.23% (P < 0.05). The JOA score increased from 8.5 preoperatively to 13.45 postoperatively with a recovery rate of 58.2% (P < 0.05). The elevated laminas were maintained open during the follow-up period. CONCLUSIONS: Our technique with sutures and bone graft for laminoplasty is a simple and efficient method for maintaining the decompression of cervical canal and neurologic improvement.