Neurospine

  • 제15권4호
  • /
  • Pages.362-367
  • /
  • 2018
  • /
  • 2586-6583(pISSN)
  • /
  • 2586-6591(eISSN)
대한척추신경외과학회 (THE KOREAN SPINAL NEUROSURGERY SOCIETY)
권호 표지
DOI QR코드

DOI QR Code

Cervical Open-Door Laminoplasty by Hydroxyapatite Implant Insertion Without Suturing

  • 투고 : 2018.04.07
  • 심사 : 2018.08.14
  • 발행 : 2018.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.

키워드

참고문헌

  1. Cho SH, Lee JH, Chough CK, et al. Hinge fracture during cervical open-door laminoplasty: does it affect clinical and radiographic outcomes? Korean J Spine 2014;11:45-51. https://doi.org/10.14245/kjs.2014.11.2.45
  2. Epstein JA. The surgical management of cervical spinal stenosis, spondylosis, and myeloradiculopathy by means of the posterior approach. Spine (Phila Pa 1976) 1988;13:864-9. https://doi.org/10.1097/00007632-198807000-00031
  3. Fujimura Y, Nishi Y. Atrophy of the nuchal muscle and change in cervical curvature after expansive open-door laminoplasty. Arch Orthop Trauma Surg 1996;115:203-5. https://doi.org/10.1007/BF00434554
  4. Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic people. Spine (Phila Pa 1976) 1986;11:521-4. https://doi.org/10.1097/00007632-198607000-00003
  5. Herkowitz HN. Cervical laminaplasty: its role in the treatment of cervical radiculopathy. J Spinal Disord 1988;1:179-88.
  6. Hirabayashi K, Satomi K. Operative procedure and results of expansive open-door laminoplasty. Spine (Phila Pa 1976) 1988;13:870-6. https://doi.org/10.1097/00007632-198807000-00032
  7. Hirabayashi K, Toyama Y, Chiba K. Expansive laminoplasty for myelopathy in ossification of the longitudinal ligament. Clin Orthop Relat Res 1999;(359):35-48.
  8. Kihara S, Umebayashi T, Hoshimaru M. Technical improvements and results of open-door expansive laminoplasty with hydroxyapatite implants for cervical myelopathy. Neurosurgery 2005;57(4 Suppl):348-56.
  9. Kim P, Wakai S, Matsuo S, et al. Bisegmental cervical interbody fusion using hydroxyapatite implants: surgical results and long-term observation in 70 cases. J Neurosurg 1998;88:21-7. https://doi.org/10.3171/jns.1998.88.1.0021
  10. Matsuzaki H, Hoshino M, Kiuchi T, et al. Dome-like expansive laminoplasty for the second cervical vertebra. Spine (Phila Pa 1976) 1989;14:1198-203. https://doi.org/10.1097/00007632-198911000-00011
  11. Nolan JP Jr, Sherk HH. Biomechanical evaluation of the extensor musculature of the cervical spine. Spine (Phila Pa 1976) 1988;13:9-11. https://doi.org/10.1097/00007632-198801000-00003
  12. Ogiso M, Tabata T, Ichijo T, et al. Bone calcification on the hydroxyapatite dental implant and the bone-hydroxyapatite interface. J Long-Term Eff Med Implant 1992;2:137-48.
  13. Petraglia AL, Srinivasan V, Coriddi M, et al. Cervical laminoplasty as a management option for patients with cervical spondylotic myelopathy: a series of 40 patients. Neurosurgery 2010;67:272-7. https://doi.org/10.1227/01.NEU.0000371981.83022.B1
  14. Ratliff JK, Cooper PR. Cervical laminoplasty: a critical review. J Neurosurg 2003;98(3 Suppl):230-8.
  15. Rhee JM, Register B, Hamasaki T, et al. Plate-only open door laminoplasty maintains stable spinal canal expansion with high rates of hinge union and no plate failures. Spine (Phila Pa 1976) 2011;36:9-14. https://doi.org/10.1097/BRS.0b013e3181fea49c
  16. Takayasu M, Takagi T, Nishizawa T, et al. Bilateral opendoor cervical expansive laminoplasty with hydroxyapatite spacers and titanium screws. J Neurosurg 2002;96(1 Suppl):22-8.
  17. Tani S, Isoshima A, Nagashima Y, et al. Laminoplasty with preservation of posterior cervical elements: surgical technique. Neurosurgery 2002;50:97-101.
  18. Tani S, Suetsua F, Mizuno J, et al. New titanium spacer for cervical laminoplasty: initial clinical experience. Technical note. Neurol Med Chir (Tokyo) 2010;50:1132-6. https://doi.org/10.2176/nmc.50.1132

피인용 문헌

  1. Upper Cervical Surgery, Increased Signal Intensity of the Spinal Cord, and Hypertension as Risk Factors for Dyspnea After Multilevel Anterior Cervical Discectomy and Fusion vol.45, pp.7, 2018, https://doi.org/10.1097/brs.0000000000003329
  2. Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty vol.64, pp.5, 2021, https://doi.org/10.3340/jkns.2020.0294