title: Single-door cervical laminoplasty using titanium miniplates alone.
abstract: OBJECTIVE
  To review outcome of 29 patients who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone.
  
  
  METHODS
  Records of 20 men and 9 women aged 35 to 79 (mean, 64.3) years who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone were reviewed. A total of 125 laminae were opened; 97 of them were fixed with a titanium miniplate. In 19 patients, a 20-hole titanium miniplate bent to the contour of a lamina was used and fixed into 3 laminae at alternate levels. In the remaining 10 patients, the pre-contoured ARCH Laminoplasty System was used and fixed into all laminae. In most patients, screw fixation was unicortical, and no spacer or bone graft was used.
  
  
  RESULTS
  The mean follow-up duration was 4 (range, 2-9) years. At one-year follow-up, the mean Japanese Orthopaedic Association (JOA) score improved from 9.2 to 13.2 (p<0.001). The mean JOA recovery rate was 64%. No patient had neurological deterioration. The mean anteroposterior diameter increased from 14.3 mm to 19.7 mm; the mean increase was 6.1 mm in the plated laminae and 5.3 mm in the unplated laminae (p=0.11). Out of the 125 laminae, there were 2 hinge non-unions in the unplated laminae, and 2 screw pullouts (not associated with plate loosening). No patient had penetration into the vertebral foramen or neuroforamen. Spring-back closure occurred in 5 (18%) of the 28 unplated laminae, with a mean of <3 mm loss of the initial expansion. Two patients developed transient C5 palsy presenting as shoulder abduction weakness. One patient had a delayed dural tear due to a sharp spike at the edge of the opened C6 lamina.
  
  
  CONCLUSIONS
  Single-door cervical laminoplasty using miniplates alone is a safe technique and achieves a high hinge union rate, good canal expansion, and neurological recovery.
authors: Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong.
authors: Kam Lung
authors: KL
authors: Tung
authors: Philip
authors: P
authors: Cheung
authors: Tik Koon
authors: TK
authors: Kwok
authors: Kam Kwong
authors: KK
authors: Wong
authors: Kan Hing
authors: KH
authors: Mak
authors: Wing Cheung
authors: WC
authors: Wong
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D065406:Laminoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D014025:Titanium
chemical_list: D014025:Titanium
keywords: laminoplasty; spinal cord diseases