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        Modified Open-Door Laminoplasty Using a Ceramic Spacer and Suture Fixation for Cervical Myelopathy

        Tomoyuki Ozawa,Tomoaki Toyone,Ryutaro Shiboi,Kunimasa Inada,Yasuhiro Oikawa,Kazuhisa Takahashi,Seiji Ohtori,Gen Inoue,Masayuki Miyagi,Tetsuhiro Ishikawa,Toshiyuki Shirahata,Yoshifumi Kudo,Katsunori In 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.6

        Purpose: To introduce a new simple technique using suture anchors and ceramic spacers to stabilize the elevated laminae in open-door cervical laminoplasty. Although ceramic spacers were placed in the opened laminae and fixed with nylon threads in this series, it was occasionally difficult to fix the nylon threads to the lateral mass. Materials and Methods: Study 1: A preliminary study was conducted using a suture anchor system. Sixteen consecutive patients who underwent surgery for cervical myelopathy were prospectively examined. Study 2: The second study was performed prospectivelyto evaluate the feasibility of this new technique based on the result of the preliminary study. Clinical outcomes were examined in 45 consecutive patients [cervical spondylotic myelopathy (CSM)] and 43 consecutive patients (OPLL). The Japanese Orthopedic Association scoring system (JOA score), axial neck pain, and radiological findings were analyzed. Results: 1) In one case, re-operation was necessary due to dislodgement of the ceramic spacer following rupture of the thread. 2) In all patients, postoperative CT scans showed that the anchors were securely inserted into the bone. In the CSM group, the average JOA score improved from 9.5 points preoperatively to 13.3 at follow-up (recovery 51%). In the OPLL group, the average JOA score improvedfrom 10.1 (5–14) points preoperatively to 14.4 (11–16) at follow-up (recovery 62%). There were no serious complications. Conclusion: The use of the suture anchor system made it unnecessary to create a hole in the lateral mass and enabled reliable and faster fixation of the HA spacers in open-door laminoplasty.

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