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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 July 2020, 7062; 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
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Hajime Yamanaka
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
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Hiroshi Tamai
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
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Tatsuya Kobayashi
1Department of Orthopaedic Surgery, Shimoshizu National Hospital, 934-5, Shikawatashi, Yotsukaido, Chiba, Japan
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Sumihisa Orita
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Miyako Narita
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Kazuhide Inage
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Hirohito Kanamoto
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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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
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Masaki Norimoto
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Tomotaka Umimura
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Takashi Sato
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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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
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Junichi Nakamura
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Tomoaki Toyone
5Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Tomoyuki Ozawa
5Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Tsutomu Akazawa
6Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
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Kazuhisa Takahashi
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Seiji Ohtori
2Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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ABSTRACT

Objective Laminoplasty is an effective procedure for treating cervical spondylotic myelopathy. We conduct myovascular preserving open-door laminoplasty (MPLP) in combination with a laminoplasty plate to improve the stability of the enlarged lamina. We compare the details of the MPLP technique with conventional open-door laminoplasty.

Methods We compared 25 cases of MPLP (mean age = 70.5, mean follow-up period = 19 months) with 15 controls who received conventional open-door laminoplasty using hydroxyapatite spacers (mean age = 74, mean follow-up period = 53 months). Regarding surgical outcomes, blood loss, operative time, Japanese Orthopaedic Association score, and postoperative visual analog score for neck pain were measured. Regarding image analysis, preoperative and postoperative range of motion (ROM), C2-7 angle, implant back out, hinge bone fusion time, presence or absence of hinge bone union failure, and posterior neck fat infiltration rate were evaluated.

Results Operative time was significantly shorter for MPLP, and postoperative neck pain was significantly decreased. In image evaluation, %ROM was significantly increased in MPLP, but no difference in C2-7 angle existed between the 2 groups. Implant back out was not recognized in either group. In MPLP, the hinge union period was significantly shortened, and the postoperative fat infiltration rate was significantly decreased.

Conclusions We were able to reduce neck pain after surgery by an approach entailing longitudinal splitting of the spinous processes. We were able to ensure shorter operation times due to cervical plates and better hinge bone fusion times due to initial stability.

Level of Evidence 4.

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

Footnotes

  • Disclosures and COI: The authors declare that they have no competing interests. We did not receive grants or external funding in support of our research or preparation of this manuscript. We did not receive payments or other benefits or a commitment or agreement to provide such benefits from any commercial entities. We declare that all protocols involving humans have been approved by the Shimoshizu National Hospital. Approval code: H25′-5.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
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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 Jul 2020, 7062; 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 Jul 2020, 7062; DOI: 10.14444/7062
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  • cervical spondylotic myelopathy
  • open-door laminoplasty
  • myovascular preservation

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