title: Box-shape cervical expansive laminoplasty: clinical and radiological outcomes.
abstract: OBJECTIVE
  Box-shape cervical expansive laminoplasty is a procedure that utilizes a Miniplate® or Maxpacer® to achieve maximal canal expansion. This method is expected to show much larger canal expansion and good clinical outcome. So we investigated the clinical and radiological outcome of Box-shape cervical expansive laminoplasty.
  
  
  METHODS
  Between June 2008 and July 2013, we performed cervical expansive laminoplasty in 87 and 48 patients using the Box-shape cervical expansive laminoplasty, respectively. We analyzed the clinical results of these operations using the Japanese Orthopedic Association (JOA) scoring system and by assessing the position of intralaminar screws with postoperative computed tomography (CT) at POD-6 months.
  
  
  RESULTS
  A total of 48 patients with ossification of the posterior longitudinal ligament (OPLL) (36 pts), cervical spondylotic myelopathy (CSM) (12 pts) were enrolled. Overall JOA scores improved from 11.49 to 14.22 at POD-6 months (OPLL: 11.32 -->14.3; CSM: 12-->14). Postoperative CT scans were performed in 39 patients at 177 levels for a total of 354 screws. The malpositioning rate of intralaminar screws was 3.4% and hardware-related neurologic complications did not occur.
  
  
  CONCLUSIONS
  Box-shape cervical expansive laminoplasty creates maximal spinal canal expansion and leads to improved cervical myelopathy. The use of intralaminar screws to fix the remodeled lamina-facet does not represent a significant difficulty.
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hae Gi
authors.initials: HG
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Ho Yeol
authors.initials: HY
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
keywords: Box-shape laminoplasty; Double door laminoplasty; Intralaminar screw; Open door laminoplasty; Spinal canal area