title: En Bloc Cervical Laminoplasty Using Translaminar Screws (T-laminoplasty): Novel Procedure for Preserving Midline Ligamentous Structures.
abstract: Prospectively maintained and retrospectively analyzed study.
  
  
  
  The authors have newly developed an en bloc cervical laminoplasty using translaminar screws (T-laminoplasty) to preserve the posterior midline structures so as to maintain spinal stability and prevent postoperative axial pain and deformity.
  
  
  
  Cervical laminoplasty is a popular surgical procedure for patients with multilevel compressive cervical lesions. However, several reports have noted its limitations and shortcomings.
  
  
  
  After exposure of the posterior cervical spine with preservation of the midline ligamentous structure, en bloc laminotomy was performed and made a laminectomized block. While the laminotomized block was being lifted, the translaminar trajectory from the lamina to the contralateral lateral mass was prepared. Then a translaminar screw was inserted with suspension of the laminotomized block to expand the spinal canal, passed through the laminar spacer, and finally fixed in the contralateral lateral mass. Next, another screw was inserted into the adjacent segment from the opposite side, and further screw fixations were made in this alternating manner.
  
  
  
  Twenty patients underwent T-laminoplasty and 83 segments were operated upon. Clinical outcomes were statistically improved during the mean follow-up period of 19.7 months. Radiologic outcomes of cervical lordosis and range of motion were preserved with the expansion of the cross-sectional area of the spinal canal. In addition, no restenosis or laminar settlement was observed at the last follow-up.
  
  
  
  T-laminoplasty can be one of the surgical options for multilevel compressive cervical lesions. With midline ligamentous structures preserving the procedure, it was possible to get enough canal decompression and foraminal decompression, while obtaining good clinical and radiologic outcomes.
authors.affiliation: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Soo Eon
authors.initials: SE
authors.lastname: Lee
authors.forename: Tae-Ahn
authors.initials: TA
authors.lastname: Jahng
authors.forename: Hyun-Jib
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D065406:Laminoplasty / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D064232:Visual Analog Scale