title: Clinical outcome and safety study of a newly developed instrumented French-door cervical laminoplasty technique.
abstract: BACKGROUND
  Standard laminectomy for treatment of cervical myelopathy is associated with secondary instability and kyphosis, while laminectomy combined with fusion puts adjacent segments at risk of degeneration. Single- and double-door laminoplasty techniques have been developed to overcome these limitations. More recently, complications related to bone graft dislodgment have fostered development of hardware-augmented laminoplasty techniques. The aim of this study is to review the clinical safety and effectiveness of a newly developed technique of instrumented French-door laminoplasty for treatment of cervical myelopathy.
  
  
  METHODS
  A series of 25 consecutive myelopathic patients were treated with a novel instrumented cervical French-door laminoplasty technique, whereby the enlarged posterior arch was held open with maxillofacial plates and screws. Patients had pre- and postoperative assessments with the Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) Score, Visual Analogue Score and radiographs. Minimum follow-up was 40 months, with regular interval assessments.
  
  
  RESULTS
  There were 18 males with a mean age of 45 years. The mean operative time was 145 min. The average hospital stay was 2.4 days and the mean follow-up was 56.5 months (40-72). All patients reported neurological improvements and there was a 35% improvement in NDI, and JOA score improved by 4.8 points. No postoperative hardware-related complications were noted and only one case of temporary C5 palsy, which completely resolved by the one-year follow-up.
  
  
  CONCLUSIONS
  Our data and clinical experience demonstrate that this hardware-augmented laminoplasty technique is safe and effective. We observed no hardware-related complications in our series. The use of readily available maxillofacial titanium miniplates and ease of surgical procedure means that this technique can be easily adopted into clinical practice.
  
  
  METHODS
  Level IV.
authors.affiliation: The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. luigianasto@gmail.com.
authors.forename: Luigi Aurelio
authors.identifier: http://orcid.org/0000-0003-3291-9911
authors.initials: LA
authors.lastname: Nasto
authors.affiliation: The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Samiul
authors.initials: S
authors.lastname: Muquit
authors.affiliation: The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Ana Belen
authors.initials: AB
authors.lastname: Perez-Romera
authors.affiliation: The Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mehdian
mesh_terms: D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation; D002574:Cervical Vertebrae; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D065406:Laminoplasty / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Cervical laminoplasty; Cervical myelopathy; Laminoplasty plate; Motion preservation