Square cervical laminoplasty incorporating spinous process: surgical technique

Abstract OPEN-DOOR EXPANSILE laminoplasty is a practical surgical technique for the treatment of cervical myelopathy secondary to cervical spinal stenosis. Laminoplasty procedures were first described in the late 1970s and have undergone numerous modifications. The current article reviews the indications, techniques, and outcome data for cervical laminoplasty. Complications of laminoplasty and comparison to laminectomy outcomes are also discussed.

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Cervical Laminoplasty by Splitting the Spinous Process Using Hydroxyapatite Spinous Process Spacer.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.43.207 ◽

1994 ◽

Vol 43 (1) ◽

pp. 207-212 ◽

Cited By ~ 1

Author(s):

Go Maeda ◽

Keiichiro Shiba ◽

Takayoshi Ueta ◽

Kenzo Shirasawa ◽

Hideki Ohta ◽

...

Keyword(s):

Spinous Process ◽

Cervical Laminoplasty

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Preserving the C7 spinous process with its muscles attached: effect on axial symptoms after cervical laminoplasty

Journal of Orthopaedic Science ◽

10.1007/s00776-009-1331-1 ◽

2009 ◽

Vol 14 (3) ◽

pp. 279-284 ◽

Cited By ~ 14

Author(s):

Kenji Kowatari ◽

Kazumasa Ueyama ◽

Akio Sannohe ◽

Yoshihito Yamasaki

Keyword(s):

Spinous Process ◽

Cervical Laminoplasty ◽

Axial Symptoms

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Operative Treatment of Cervical Myelopathy: Cervical Laminoplasty

Advances in Orthopedics ◽

10.1155/2012/508534 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Brett A. Braly ◽

David Lunardini ◽

Chris Cornett ◽

William F. Donaldson

Keyword(s):

Surgical Technique ◽

Cervical Spondylotic Myelopathy ◽

Surgical Intervention ◽

Treatment Options ◽

Clinical Signs ◽

Signs And Symptoms ◽

Technical Difficulty ◽

Cervical Laminoplasty ◽

Open Door ◽

Clinical Signs And Symptoms

Cervical spondylotic myelopathy (CSM) is a degenerative process which may result in clinical signs and symptoms which require surgical intervention. Many treatment options have been proposed with various degrees of technical difficulty and technique sensitive benefits. We review laminoplasty as a motion-sparing posterior decompressive method. Current literature supports the use of laminoplasty for indicated decompression. We also decribe our surgical technique for an open-door, or “hinged”, laminoplasty.

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Midline Spinous Process-splitting Cervical Laminoplasty with Titanium Plates

Spinal Surgery ◽

10.2531/spinalsurg.31.177 ◽

2017 ◽

Vol 31 (2) ◽

pp. 177-179

Author(s):

Seishi Matsui ◽

Naoki Shinohara ◽

Toshimoto Seno ◽

Taro Kusakabe ◽

Toshifumi Utsunomiya ◽

...

Keyword(s):

Spinous Process ◽

Cervical Laminoplasty

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Relationship Between C2 Semispinalis Cervicis Preservation and C2 Spinous Process Morphology During Cervical Laminoplasty Involving C3

Global Spine Journal ◽

10.1177/21925682211062496 ◽

2021 ◽

pp. 219256822110624

Author(s):

Sang Yun Seok ◽

Dong-Ho Lee ◽

Hyung Rae Lee ◽

Sehan Park ◽

Jae Hwan Cho ◽

...

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Neck Pain ◽

Clinical Outcomes ◽

Cervical Myelopathy ◽

Spinous Process ◽

Three Dimensional ◽

Anatomical Variations ◽

Cervical Laminoplasty ◽

The Relationship

Study Design Retrospective study Objectives Due to anatomical variations in the semispinalis cervicis insertion in the C2 spinous process, complete preservation is not always possible when the C3 level is included in a cervical laminoplasty. Three-dimensional computed tomography was used to evaluate the relationship between the incidence of semispinalis cervicis injury and the C2 inter-spinous angle. Methods We included 95 patients who underwent a cervical laminoplasty that included a C3 laminectomy for cervical myelopathy. Patients with a C2 inter-spinous angle above and below 60° were classified into wide- and narrow-angled groups, respectively (n = 48 and n = 47). Whether the C2 semispinalis cervicis insertion was preserved, or detached and reattached was reviewed from surgical records. The pre and postoperative C2-C7 lordosis and range of motion (ROM) were measured, and clinical outcomes were obtained from the patient charts. Results The C2 semispinalis cervicis was preserved in 47 patients (97.9%) in the wide-angled group but only in 14 patients (29.8%) in the narrow-angled group ( P < .001). The postoperative C2-C7 lordosis extension and ROM were significantly greater in the wide-angled ( P = .048 and .036). Postoperative neck pain was significantly greater in the narrow-angled ( P = .018). Conclusions The morphology of the C2 spinous process indicates that a C2 semispinalis cervicis insertion preservation is possible during a cervical laminoplasty that includes a C3 laminectomy. A careful surgical procedure should be conducted when the C2 inter-spinous angle is above 60° to increase the likelihood of achieving this preservation and thereby obtaining a more favorable clinical outcomes.

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Analysis of Cervical Spine Alignment Change after Modified Kurokawa Cervical Laminoplasty in the Patients with Cervical Myelopathy and Straight Cervical Spine

BioMed Research International ◽

10.1155/2021/6658766 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Shangbin Cui ◽

Fuxin Wei ◽

Xizhe Liu ◽

Shaoyu Liu

Keyword(s):

Cervical Spine ◽

Spinous Process ◽

Neutral Position ◽

Cervical Laminoplasty ◽

Intervertebral Disc Space ◽

Cervical Alignment ◽

T1 Slope ◽

Angle Change ◽

Cervical Sagittal Alignment

Laminoplasty is widely used to decompress the spinal cord in patients with multilevel cervical lesions. Straight cervical alignment may not be a good candidate for laminoplasty because of postoperation progression of kyphosis and loss of cervical spine range of motion (ROM). However, clinical outcomes of laminoplasty did not show a strong and consistent effect based on cervical sagittal alignment. Moreover, the kyphosis progression and ROM change after operation for the patients with preoperative strange cervical alignment are still unclear. This study is to evaluate the change of cervical alignment and ROM in patients with straight cervical alignment after modified Kurokawa cervical laminoplasty. Thirty patients with multiple-level cervical spondylosis (CSM) and straight cervical alignment were included. All patients underwent laminoplasty with the reconstruction of the spinous process-ligament-muscular complex (SPLMC). The modified JOA score was analyzed for clinical assessment. The change of cervical alignment, ROM, T1 slope, and intervertebral disc space Cobb angle were analyzed for radiological assessment. The average JOA score at preoperative and 2 years follow-up were 7.8 ± 1.4 and 13.6 ± 2.1 , respectively. The recovery ratio was 63%. At the 2 years follow-up, there were 18 patients who acquired lordotic cervical alignment. 10 patients remained as straight cervical curve, and 2 patients’ cervical alignment developed mild kyphosis. 28 out of 30 patients showed improvement of cervical alignment. The cervical alignment was improved from 1.29 ± 10.04 ° preoperative to 9.58 ± 8.65 ° postoperative. However, the ROM decreased from 36.8 ± 18.92 preoperative to 25.08 ± 12.10 ° postoperative. A positive correlation was found between the C2/4 angle change and cervical alignment change, T1 slope and cervical alignment, cervical alignment, and neutral position flexion reserved ROM. A negative correlation was found between the C1/2 angle change and cervical alignment change. Laminoplasty with a reconstruction of SPLMC followed by appropriate postoperative muscle exercises may be an encouraging way to maintain or improve physiological alignment and prevent postoperation kyphosis deformity at 2 years follow-up.

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