title: Modified Open-Door Laminoplasty Using a Ceramic Spacer and Suture Fixation for Cervical Myelopathy.
abstract: OBJECTIVE
  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.
  
  
  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 prospectively to 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 improved from 10.1 (5-14) points preoperatively to 14.4 (11-16) at follow-up (recovery 62%). There were no serious complications.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Teikyo Chiba Medical Center, Ichihara, Japan. tomokun@wg7.so-net.ne.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Teikyo University School of Medicine, Teikyo University Hospital, Mizonokuchi, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Teikyo Chiba Medical Center, Ichihara, Japan.
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Shiboi
authors.affiliation: Katsuura Orthopeadic Clinic, Katsuura, Japan.
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Inada
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Teikyo Chiba Medical Center, Ichihara, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.affiliation: Department of Orthopedic Surgery, Kitazato University Hospital, Sagamihara, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.affiliation: Department of Orthopedic Surgery, Kitazato University Hospital, Sagamihara, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.affiliation: Department of Orthopedic Surgery, Sanmu Medical Center, Sanmu, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.affiliation: Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Shirahata
authors.affiliation: Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Inagaki
mesh_terms: D000328:Adult; D000368:Aged; D002516:Ceramics; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D065406:Laminoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013118:Spinal Cord Diseases / Q000601:surgery*; D053441:Suture Anchors; D013537:Sutures; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Open-door laminoplasty; ceramic spacer; suture anchor fixation