Minimally invasive cervical expansile laminoplasty: an initial cadaveric study.
OBJECTIVE
Expansile laminoplasty has been successfully used to treat cervical myelopathy attributable to canal stenosis. However, detachment of the posterior cervical muscles is thought to contribute to postoperative axial neck pain and kyphosis. Minimizing the amount of muscular dissection might reduce the likelihood of these sequelae.


METHODS
Six human cadaveric spines were used to assess the feasibility of a minimally invasive laminoplasty technique. A 22-mm tubular dilator port was used to access the lamina-facet junctions from C2 to C7, through bilateral stab incisions at C4-C5 and C5-C6. Troughs at the lamina-facet junctions were drilled bilaterally, and the contiguous laminae were lifted en bloc from one side. Ten-millimeter rib allograft spacers were inserted to maintain a gap on the open side.


RESULTS
Exposure of six cervical levels was easily accomplished with two small incisions on each side. Drilling was achieved without dural violations. The midsagittal spinal canal diameter was increased by a mean of 38% and the spinal canal area was increased by an average of 43% at the level of C5.


CONCLUSIONS
A minimally invasive approach for cervical laminoplasty could be performed in human cadavers. The measured increases in spinal canal space approximated those demonstrated to be associated with stabilization or improvement of neurological status.
Wang
Michael Y
MY
Department of Neurological Surgery, University of Miami, Miami, Florida, USA. myw@usc.edu
Green
Barth A
BA
Coscarella
Ernesto
E
Baskaya
Mustafa K
MK
Levi
Allan D O
AD
Guest
James D
JD
D016025:Bone Transplantation / Q000295:instrumentation*; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D013115:Spinal Canal / Q000473:pathology; D013117:Spinal Cord Compression / Q000473:pathology / Q000601:surgery*; D013130:Spinal Stenosis / Q000473:pathology / Q000601:surgery*; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed