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Research ArticleCervical Spine

Myovascular Preserving Open-Door Laminoplasty for Cervical Spondylotic Myelopathy With Miniplate Fixation

YAWARA EGUCHI, MUNETAKA SUZUKI, HAJIME YAMANAKA, HIROSHI TAMAI, TATSUYA KOBAYASHI, SUMIHISA ORITA, MIYAKO NARITA, KAZUHIDE INAGE, HIROHITO KANAMOTO, KOKI ABE, MASAHIRO INOUE, MASAKI NORIMOTO, TOMOTAKA UMIMURA, TAKASHI SATO, YASUCHIKA AOKI, ATSUYA WATANABE, MASAO KODA, TAKEO FURUYA, JUNICHI NAKAMURA, TOMOAKI TOYONE, TOMOYUKI OZAWA, TSUTOMU AKAZAWA, KAZUHISA TAKAHASHI and SEIJI OHTORI
International Journal of Spine Surgery August 2020, 14 (4) 476-482; DOI: https://doi.org/10.14444/7062
YAWARA EGUCHI
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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MUNETAKA SUZUKI
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
MD, PHD
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HAJIME YAMANAKA
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
MD, PHD
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HIROSHI TAMAI
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
MD, PHD
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TATSUYA KOBAYASHI
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
MD, PHD
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SUMIHISA ORITA
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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MIYAKO NARITA
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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KAZUHIDE INAGE
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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HIROHITO KANAMOTO
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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KOKI ABE
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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MASAHIRO INOUE
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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MASAKI NORIMOTO
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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TOMOTAKA UMIMURA
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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TAKASHI SATO
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD
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YASUCHIKA AOKI
3Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba, Japan
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ATSUYA WATANABE
3Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba, Japan
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MASAO KODA
4Department of Orthopedic Surgery, University of Tsukuba, Ibaraki, Japan
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TAKEO FURUYA
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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JUNICHI NAKAMURA
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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TOMOAKI TOYONE
5Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
MD, PHD
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TOMOYUKI OZAWA
5Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
MD, PHD
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TSUTOMU AKAZAWA
6Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
MD, PHD
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KAZUHISA TAKAHASHI
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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SEIJI OHTORI
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
MD, PHD
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    Figure 1

    Intraoperative photographs (A)–(E) and cross-section schematic representation (a)–(e) of myovascular preserving open-door laminoplasty. (A), (a) Retracting the apex of the spinous processes; arrow: spinous process tips at C4, C5, and C6. (B), (b) The spinous process is cut longitudinally by a 2-mm diamond shaped drill, the spinous processes are removed at the spinolaminar junction and retracted bilaterally with the muscles attached; arrow: cortical bone of the spinous processes; arrowhead: cross-section of the base of the spinous processes. (C), (c) The surface of the lateral part of the lamina is exposed by retracting of the split spinous process together with the attached semispinalis cervicis and multifidus muscles. (D), (d) The miniplate is anchored to the opened lamina by 2 5-mm miniscrews and anchored to the lateral mass by 2 5-mm miniscrews. (E), (e) The spinous process with muscles attached is reconstructed by suturing.

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    Figure 2

    Analysis of posterior cervical muscle fat infiltration rate. Cervical cross-section computed tomography images were analyzed using AZE VirtualPlace. Fat in the posterior cervical muscles is labeled in blue. Posterior cervical muscle fat infiltration proportion (%) = (cross-sectional area of posterior cervical intramuscular fat [blue]/cross-sectional area of posterior neck muscle [dotted line]) × 100.

  • Figure 3
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    Figure 3

    C4-6 myovascular preserving open-door laminoplasty postoperative three-dimensional computed tomography image. (A) posteroanteriorimage; (B) lateral view. A plate is placed on C5. Spinous processes that had been split also remained in the center and remained bone.

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International Journal of Spine Surgery
Vol. 14, Issue 4
1 Aug 2020
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Myovascular Preserving Open-Door Laminoplasty for Cervical Spondylotic Myelopathy With Miniplate Fixation
YAWARA EGUCHI, MUNETAKA SUZUKI, HAJIME YAMANAKA, HIROSHI TAMAI, TATSUYA KOBAYASHI, SUMIHISA ORITA, MIYAKO NARITA, KAZUHIDE INAGE, HIROHITO KANAMOTO, KOKI ABE, MASAHIRO INOUE, MASAKI NORIMOTO, TOMOTAKA UMIMURA, TAKASHI SATO, YASUCHIKA AOKI, ATSUYA WATANABE, MASAO KODA, TAKEO FURUYA, JUNICHI NAKAMURA, TOMOAKI TOYONE, TOMOYUKI OZAWA, TSUTOMU AKAZAWA, KAZUHISA TAKAHASHI, SEIJI OHTORI
International Journal of Spine Surgery Aug 2020, 14 (4) 476-482; DOI: 10.14444/7062

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Myovascular Preserving Open-Door Laminoplasty for Cervical Spondylotic Myelopathy With Miniplate Fixation
YAWARA EGUCHI, MUNETAKA SUZUKI, HAJIME YAMANAKA, HIROSHI TAMAI, TATSUYA KOBAYASHI, SUMIHISA ORITA, MIYAKO NARITA, KAZUHIDE INAGE, HIROHITO KANAMOTO, KOKI ABE, MASAHIRO INOUE, MASAKI NORIMOTO, TOMOTAKA UMIMURA, TAKASHI SATO, YASUCHIKA AOKI, ATSUYA WATANABE, MASAO KODA, TAKEO FURUYA, JUNICHI NAKAMURA, TOMOAKI TOYONE, TOMOYUKI OZAWA, TSUTOMU AKAZAWA, KAZUHISA TAKAHASHI, SEIJI OHTORI
International Journal of Spine Surgery Aug 2020, 14 (4) 476-482; DOI: 10.14444/7062
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Keywords

  • cervical spondylotic myelopathy
  • open-door laminoplasty
  • myovascular preservation

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