A Goel1. 1. Department of Neurosurgery, King Edward Memorial Hospital, Bombay, India.
Abstract
BACKGROUND: Various advantages of a laminoplasty over the conventional laminectomy have been listed in the recent literature. An alternative method of vascularized pedicled laminoplasty is described in this report. METHODS: A linear cut is made in the laminae in their lateral aspects and two or more laminae are elevated as a flap and pedicled on supraspinous, interspinous, and interlaminar ligaments. The procedure was performed in 10 cases where surgery was performed for spinal intradural pathology. The ages of these patients ranged from 21 to 60 years. RESULTS: In an average observation period of 8 months, no demonstrable resorption of the laminar flap was observed in any case. None of the patients complained of any additional discomfort, pain, or deformity that could be related to the laminoplasty. CONCLUSIONS: Laminoplasty using laminae with a vascularized pedicle as described may be better tolerated by the patient; the segment seems to be more resistant to infection and radiotherapy. It is a simple, safe, and stable alternative to the procedures of laminoplasty previously described. No sophisticated instrumentation, prosthetic material, or technically complex maneuvers are required to harvest and reposition the laminar flap.
BACKGROUND: Various advantages of a laminoplasty over the conventional laminectomy have been listed in the recent literature. An alternative method of vascularized pedicled laminoplasty is described in this report. METHODS: A linear cut is made in the laminae in their lateral aspects and two or more laminae are elevated as a flap and pedicled on supraspinous, interspinous, and interlaminar ligaments. The procedure was performed in 10 cases where surgery was performed for spinal intradural pathology. The ages of these patients ranged from 21 to 60 years. RESULTS: In an average observation period of 8 months, no demonstrable resorption of the laminar flap was observed in any case. None of the patients complained of any additional discomfort, pain, or deformity that could be related to the laminoplasty. CONCLUSIONS: Laminoplasty using laminae with a vascularized pedicle as described may be better tolerated by the patient; the segment seems to be more resistant to infection and radiotherapy. It is a simple, safe, and stable alternative to the procedures of laminoplasty previously described. No sophisticated instrumentation, prosthetic material, or technically complex maneuvers are required to harvest and reposition the laminar flap.