Artikel
Open-book laminoplasty. Going the Japanese way? Indications, technique and outcome in a single German institution
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Autoren
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Christopher Held
- Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
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Thomas Linsenmann
- Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
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Thomas Westermaier
- Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
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Christian Stetter
- Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
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Ralf-Ingo Ernestus
- Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: In Japan cervical laminoplasty is a common technique for the treatment of cervical myelopathy resulting from multilevel spinal canal stenosis, especially in OPLL. The goal of this technique is to increase the space of the spinal canal and to reconstruct the posterior arch at the same time without destabilizing the integrity of the spine. We present our experience and the outcome of two patients that have undergone an open-book laminoplasty using a specific clamp offered by Spineart®. We discuss indications, outcome, advantages and disadvantages of this technique.
Methods: We report the cases of a 61 years old female patient and a 46 years old male patient with cervical myelopathy due to multilevel spinal canal stenosis, who underwent an open-book laminoplasty. We describe the perioperative course and the clinical and radiographic follow-up after 3 and 6 months. We embedded our results in the available literature about laminoplasty techniques and discuss critically our own experiences in using this device.
Results: Both patients suffered from chronic myelopathy and underwent operation in form of an open-book laminoplasty. Postoperative we found a relevant regression of myelopathy in one patient and a severe posterior cord syndrome due to decompression and manipulation in the male patient. Radiological assessment during follow-up showed the inserted laminoplasty material well positioned without any signs of destabilization of the cervical spine. The patients do not suffer from increased or new neck pain.
Conclusion: While not the standard procedure in Germany in cases of multilevel spinal canal stenosis of the cervical spine, open-book laminoplasty presents as a valid and cheaper alternative to the more common spinal decompression plus spondylodesis procedure. The longtime results of open-book-laminoplasty have been evaluated in the past with an excellent outcome in OPLL patients. In cases of multilevel stenosis due to spondylotic myelopathy we plan to initiate a longitudinal multicenter study.
Figure 1 [Fig. 1]
