Introduction: Lamina closure is the most common reason for failure of unilateral open-door laminoplasty. Centerpiece micro-plate fixation is design to solve the problem. We assessed its effectiveness by comparing it with suture suspension fixation.
Methods: 90 patients with multi-segment cervical spondylotic myelopathy were included between January 2008 and December 2010. 66 patients underwent laminoplasty by centerpiece micro-plate fixation (centerpiece group) and the others underwent laminoplasy by suture suspension fixation (traditional group). Neurological recovery was measured by Japanese Orthopedic Association (JOA) score. The spinal canal expansive was evaluated by X-ray film, MRI, and CT scan.
Results: There were no significant difference in gender (?2=1.168,p=0.271), age (60.7±1.5vs.62.1±2.2,p=0.625), preoperative JOA score (7.5±3.4vs.7.8±2.8,p=0.325), preoperative Pavlov’s ratio (0.47±0.2vs.0.44±0.2,p=0.318) , blood loss (272±22vs.219±39,p=0.218) between centerpiece group and traditional group. The mean follow-up time was 23(6-38) months. Postoperative JOA score in centerpiece group was 12.7±4.1and in traditional group was 12.1±4.4. They were all significantly higher than the preoperative scores (P<0.001). But there was no significant difference between them (P=0.371). The centerpiece group had a significant higher Pavlov’s ratio than traditional group after operations (0.89±0.2vs.0.80±0.3,p=0.016). The expansive rate of spinal canal between 2 groups didn’t have significant difference (122±10%vs.99±11%,P=0.247) after operation immediately, but had significant difference at the end of follow-up (117±8%vs.83±11%,p=0.025). In centerpiece group, this didn’t happen. 3 patients were observed lamina closure; they were all in traditional group. The rate of complications in centerpiece group(18.2%, 12/66) was lower than that in traditional group(37.5%,9/24) significantly(?2=4.420, p=0.038).
Conclusions: Laminoplasty by centerpiece micro-plate fixation maintain the expansive stability, bring fewer complications and avoid lamina closure effectively.
Patient Care: Comparing the differences results between the two fixation methords in laminoplasty to help doctors and patients to select a porper surgical approach.
Learning Objectives: By the conclusion of this session, participants should be able to: 1)Descripe the technique of unilateral open-door laminoplasty with centerpiece micro-plate fixation; 2)Identify the effectiveness of centerpiece micro-plate fixation comparing with the traditional fixation methord in laminoplasty