Tomoyuki Ozawa1, Tomoaki Toyone2, Ryutaro Shiboi3, Kunimasa Inada4, Yasuhiro Oikawa3, Kazuhisa Takahashi5, Seiji Ohtori5, Gen Inoue6, Masayuki Miyagi6, Tetsuhiro Ishikawa7, Toshiyuki Shirahata8, Yoshifumi Kudo8, Katsunori Inagaki8. 1. Department of Orthopedic Surgery, Graduate School of Medicine, Teikyo Chiba Medical Center, Ichihara, Japan. tomokun@wg7.so-net.ne.jp. 2. Teikyo University School of Medicine, Teikyo University Hospital, Mizonokuchi, Japan. 3. Department of Orthopedic Surgery, Graduate School of Medicine, Teikyo Chiba Medical Center, Ichihara, Japan. 4. Katsuura Orthopeadic Clinic, Katsuura, Japan. 5. Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. 6. Department of Orthopedic Surgery, Kitazato University Hospital, Sagamihara, Japan. 7. Department of Orthopedic Surgery, Sanmu Medical Center, Sanmu, Japan. 8. Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan.
Abstract
PURPOSE: 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. MATERIALS AND 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. CONCLUSION: 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.
PURPOSE: 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. MATERIALS AND 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. CONCLUSION: 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.