Use of small suture anchors in cervical laminoplasty to maintain canal expansion: a technical note.
OBJECTIVE
Open door laminoplasty is a commonly performed procedure for the treatment of cervical spine pathology. One complication of this procedure is closure of the hinge and subsequent restenosis. A simple and effective method of using suture anchors to stabilize posterior elements has been previously described. The aim of this paper is to describe our experience using 2.0-mm suture anchors to maintain canal expansion.


METHODS
Results of 42-consecutive patients who were treated with a modified cervical open-door laminoplasty were reviewed. The modification involves the use of original Hirabayashi technique, but augmenting the canal expansion with 2.0-mm suture anchors at C3, C5, and C7 levels. Additionally, nonabsorbable sutures are placed at C4 and C6 levels as described by Hirabayashi. The technical issues and short-term radiographic outcomes were evaluated.


RESULTS
None of the 42 patients who had the door secured with 2.0-mm suture anchors had closure of the hinge. Additionally, the suture anchors maintained their position without loosening or "pull-outs" on postoperative follow-up radiographs. There were 3 short-term complications: 1 was a small dural-tear which was repaired intraoperatively without further sequelae, and the other 2 were both epidural hematomas that required emergent return to the operating room for evacuation. All 3 patients had an uneventful recovery without a new neurologic deficit.


CONCLUSIONS
This paper reviews a simple and effective method for maintaining canal expansion in open-door laminoplasty. Because of its technical simplicity, 2.0-mm suture anchors may be a safer alternative than other devices currently popular for this purpose.
Lee
Joon Y
JY
Department of Orthopaedics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. joonyunglee@yahoo.com
Hanks
Stephen E
SE
Oxner
William
W
Tannoury
Chadi
C
Donaldson
William F
WF
Kang
James D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D004388:Dura Mater / Q000293:injuries; D046748:Hematoma, Epidural, Spinal / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007796:Laminectomy / Q000295:instrumentation* / Q000379:methods; D008488:Medical Illustration; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013130:Spinal Stenosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D053441:Suture Anchors / Q000592:standards* / Q000706:statistics & numerical data; D016896:Treatment Outcome